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Student Registration form
Refund
Policy: NO REFUNDS.
If you
are unable to attend due to an emergency and you let us know as soon as
possible, you MAY at OUR DISCRETION be allowed one "rain check" date. A
no call / no show will not get a rain check.
Please fill out and
mail in form and check or money order for $140, payable to
“Patrick Smith”, at 4504 South 16th Street, Omaha, NE 68107
at least two weeks before class date (to allow check to clear). Once
the form is received we will call or E-mail you to confirm the class
date. Classes will be filled first paid, first served- always give 1st
and 2nd choice class dates.
Classroom
location is 3941 “V” Street
Student Full Name:
_______________________________________________
Gender:_____________ Age: _____________ Date of Birth:_______________
Complete Address:
________________________________________________
City
________________________________________Zip________________
Phone number:
___________________________________________________
E-mail address:
___________________________________________________
Nebraska Driver’s
License Number: ___________________________________
Dates of class
wanted: 1st choice ___________________ 2nd
choice __________________ See class schedule
on website. Class seats are filled on first paid, first served basis,
and classes fill up fast. Classes are limited to 20 students.
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GUN-SAFE Academy