This form must be complete with valid information!

Your Contact Information

First Name: Last Name: Phone:

Street Address:

City: State: Zip Code: DOB:

Email Address:

Are you an NRA Member? Yes No

If you answered Yes to the above please enter your NRA ID number:

Are you Registered with the BSA? Yes No --- BSA Council District:

If you are registered with the BSA please enter your ID number:

Are you a Member of:

Beaverbrook Sportsman's Club? Yes No

Course Selections
Basic Level Classes: (An interest and a good attitude are all that's required)

Archery & BB-Gun Range Master (March 2)

NRA Range Safety Officer (March 2)

      All the classes are at Beaverbrook Sportsman's Club --- East Bethel.