Individual Registration


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    Shaded Fields Are Required 

Class Date:

*First Name:
*Middle Name: (If no middle name, enter "NONE")
*Last Name:
*Generation  (Jr., II, etc....  Or, enter "NONE")
     Nickname  (If no nickname, leave blank)

*must be the same as Drivers License or State ID

Phone: (include area code)
Alt. phone: (include area code)
  (Your email address will be added to our free News Letter list.  You may opt-out at any time):
Date of birth:
Form of identification:

Issuing state:

DL or ID number:
Would you like to qualify with one of our handguns?  (semi-automatic only)  

Participation in our LTC Class will require that you sign a Hold Harmless Agreement that will be provided to you on the day of the class.

If you wish to review the terms and conditions of the Agreement CLICK HERE.

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Promo Code: 

Credit card Information:

Billing Amount:
Texas License To Carry Class $125.00
(Must be on Active Duty status, on date of class)
Card Issuer:
Card Number:
Expiration Date:
Card Verification Number:  (3 digit number printed on back of card - If un-readable, enter "NONE")
Name on Card:
Billing Address:
Street or PO Box City State ZIP

CLICK HERE for an explanation of our Cancellation and Re-scheduling Policies.

By submitting this form, I acknowledge that I have read and accept the terms and conditions of the Staying Alive, Inc., Cancellation and Re-scheduling policies.

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