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CPL_Class_Registration

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					                                  CPL Registration Form
                               Please fax completed form to 989-266-3128
Please print clearly.
Name____________________________________________________________
       (First)                               (Middle)                      (Last)


Address___________________________________________________________
          (Number)                     (Street)                                           (Apt)


City__________________________                          State MI   Zip______________________

Date of Birth_____________________                      Telephone_________________________
                        (mm/dd/yyyy)                                          (xxx-xxx-xxxx)


CPL Class Registration Date ____________________
Order
  Deposit $50.00 (required to hold spot, remainder due at CPL Class)
  Class Registration $125.00 (for full payment, and to hold spot)
  Gun Rental (.22 cal with 100 rounds) $15.00

Payment Total __________________

For payment with credit card:
Credit Card NO ____________________________
Billing Zip_________________
CSC NO___________________


                                  CPL Registration Form
                               Please fax completed form to 989-266-3128
Please print clearly.
Name____________________________________________________________
       (First)                               (Middle)                      (Last)


Address___________________________________________________________
          (Number)                     (Street)                                           (Apt)


City__________________________                          State MI   Zip______________________

Date of Birth_____________________                      Telephone_________________________
                        (mm/dd/yyyy)                                          (xxx-xxx-xxxx)


CPL Class Registration Date ____________________
Order
  Deposit $50.00 (required to hold spot, remainder due at CPL Class)
  Class Registration $125.00 (for full payment, and to hold spot)
  Gun Rental (.22 cal with 100 rounds) $15.00

Payment Total __________________

For payment with credit card:
Credit Card NO ____________________________
Billing Zip_________________
CSC NO___________________

				
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