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Online Course Registration
For a printable version of the registration form,
click here.
(.doc)
*
= Required
*
First Name:
*
Middle Name:
*
Last Name:
*
Date of Birth (M/D/Y):
*
Gender:
You only need to fill out either: Drivers License Number, Firearms Number or MDNR Number (not all).
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Drivers License Number:
or:
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Firearms Number:
or:
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MDNR Number:
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Telephone Number:
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Complete Mailing Address (No. & Street, RFD, and/or PO Box No, City, State, Zip Code):
*
Height (feet/inches):
*
Weight (lbs):
*
Eye Color:
Email:
*
County: