Instructor Training Course Registration Form

This is the first step to registering for the NRA Instructor Training Course.

The NRA instructor training courses will be held May 14-15 and May 21-22, 2005. The courses will be held at Kenmore Gun Range and other local gun clubs - please check the website and your registration package for specific details on class locations.

The course fee is $100.
Please enter the following information.

First Name:

Last Name:

Email:

Mailing Address:

City:

State:

Zip:

Daytime Phone:

Evening Phone:

What do you want to get certified to teach?

Do you currently hold ratings as an NRA Basic Firearm Training Instructor or NRA Shooting Coach?

If yes, what NRA instructor certifications do you hold?

Why do you wish to become and NRA Certified Instructor?

Where do you plan to conduct the classroom and range portions of your NRA Basic Firearm Training Courses?

After your earn your endorsement for instructor certification, your NRA Training Counselor is responsible for helping you find an instructor team. As a member of this team, you will work with others to organize and conduct NRA Basic Firearm Courses. Do you personally know any NRA Certified Instructors with whom you would like to work? If so, what are their names?

Briefly describe any previous teaching experience (shooting or non-shooting related)

Briefly describe your shooting experience with rifles, pistols, shotguns, muzzleloading firearms, and air guns.
List the types of guns you have fired (e.g., bolt action rifle, semi-automatic pistol), how long you have been shooting them, how often you shoot them, how many rounds you have fired in the past six months, and the types of activities in which you participate with these guns. Please also list any firearms training courses that you have taken.

You should have a rating in a competitive shooting discipline relevant to the area(s) that you are getting certified to teach. If you do not have a rating, you should provide proof of completion of at least 3 matches or recognized courses of fire within the past 12 months. If you do not have documented shooting experience, you must have taken the NRA Basic Course(s) that you are getting certified to teach within the past 12 months.
Please list either a, b or c:
(a) Relevant ratings that you hold in competitive shooting disciplines (e.g. NRA Highpower Sharpshooter, IPSC C Class Limited, etc.) and the month and year in which you attained that rating.
(b) List at least 3 separate matches, shoots or standard courses of fire that you shot in the past 12 months - the date, location and and score or ranking you obtained. For example, "June IDPA Match at Renton Fish and Game, Finished #10 out of 25 competitors.", "Sept 10, shot 3 rounds of trap at Kenmore Range, scored 23/25, 22/25, 24/25.", "Sept 15, Snoqualmie Valley Rifle Club, NRA Marksmanship Qualification Program, completed Light Rifle Sharpsoooter, Expert and Distinguished Expert Courses of fire."
(c) The date, location and contact information for the instructor who taught your NRA Basic Course(s).
Please bring documentation (classification card(s), copies of match results, NRA Basic Course Completion Certificates) to the instructor training course.

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First Name:
Last Name:
Email:
Mailing Address:
City:
State:
Zip:
Daytime Phone:
Evening Phone:
What do you want to get certified to teach?