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2. Type of Organization or Business*
4. Name of Organization or Business*
6. Address*
8. Contact Name for Organization or Business*
10. Contact Person's phone number*
12. Contact Person's email address*
14. Number of potential attendees for the class*
16. What date and time are you requesting?*
    What date and time are you requesting?

    What date and time are you requesting?
18. Does your organization have the ability to host the course with necessary media materials? (Projector/Projector Screen/TV large enough to view from a distance/sound and audio equipment)?*

    1. Yes
    2. No
20. Can your organization allot 2 hours to this course?*

    1. Yes
    2. No
24. I understand that this is NOT a firearms course. *

    1. Yes
    2. No
26. I understand that this course is NOT intended for children, and therefore, children are not permitted to attend. *

    1. Yes
    2. No
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28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

* indicates a required field