Registration Form

Online Registration Form (you must click the SUBMIT button)

Please complete all of the information fields below BEFORE you click the "SUBMIT" button. All information is required, and all (except for the phone and the email) will be forwarded to the Nebraska State Patrol upon successful completion of the class as part of the Nebraska Concealed Handgun Permit application process.

The fee for the course is $175 (no credit cards; only check or cash).  The fee includes the classroom/range time, a thorough 162-page course manual AND numerous resourceful pertinent articles and other reference sources. Registration and payment must be received no later than1 week prior to the course date so that course materials can be prepared in time for the class. Reservations for the class is on a first-registered/paid basis; should all of the openings in the class be filled by the time your registration and payment is received, you will be notified.

Please make checks payable to "Ronald Attanasio" and mail to:
     Ronald Attanasio
     141 S 90th Street
     Apt 417
     Lincoln, NE 68520

Which class date? *

Requesting a customized class (submit the contact form to make arrangements)

* Indicates required field

Name as it appears on driver's license *

Driver's license # / Military ID # *

Driver's license state *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Age (on the day of the class) *

Date of birth mm/dd/yyyy *

Gender *

Email *

Re-enter Email *

Phone Number *

Level of handgun experience *

YOU MUST CLICK THE "SUBMIT" BUTTON TO SEND IN YOUR REGISTRATION INFORMATION ONLINE.

Submit