Training Registration

NM Elite Firearms & Training, LLC
3205 Luna Drive, Las Vegas NM 87701
Phone: 505.425.2808 Fax: 505.425.6745
First Name(*)

Middle Name or Initial

Last Name(*)

Last Four of Soc. Sec. No. / NMDPS Cert. No.(*)

Date of Birth (MM/DD/YYYY)(*)
Invalid Input

Rank/Job Title

Agency Name (If None, enter "Self")(*)

Home Mailing Address(*)

Agency Billing Address

Phone Number(*)

Fax Number

Email Address

Type of Course
Invalid Input

Training Location (City)

First Day of Course

Invalid Input

Course Requested
Invalid Input

Total Payment
0.00 USD

Payment Type
Invalid Input

Jurisdictional Function (Check One Only)
Invalid Input

Agency Type (Check One Only)
Invalid Input