RTBAV Instructor Development Workshop Application

Please enter your information on this form. It will be emailed to the RTBAV department at NRA Headquarters.

Name:
Email:
Mailing Address:
City:
State:
Zip:
Daytime Phone:
Evening Phone:

Fax:

Company:

Occupation:

Clubs Organizations or Affiliations
Name, Status (office, member, volunteer, etc.)

Experience
Please list your previous experience in instructing others (i.e. CPR or First-Aid, self-defense courses, computer training, etc.)
Subject, Age Group, Year

Are you currently an NRA certified instructor

Training
Please list experience in presentations, lectures, seminars, direct sales or any speech courses (college, Toastmasters, etc.) you have completed.
School, Instructor or Organization Name, Course Title, Year Completed

Please list any other training experience you feel might enhance your ability to instruct others in Refuse To Be A Victim.

What has been your motivation to become a Refuse To Be A Victim instructor?

What do you hope to accomplish through involvement with the program?

By clicking submit, you are posting your data to refuse@nra.org. This is not an official NRA website.

Name:
Email:
Mailing Address:
City:
State:
Zip:
Daytime Phone:
Evening Phone:
Fax:
Company:
Occupation: