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1143
LTC Class Registration Form: Lee Watkins-Rev1
All information marked with (*) is required.
List your name as you want it on your class name badge. It must include your last name,
but you can use a legal first name or nickname.
Name
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List your legal name as it appears on your driver's license.
First Name
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Please let us know your name.
Middle Initial (Enter NMI if no middle name)
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Last Name
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Suffix
Jr.
Sr.
II
III
IV
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Driver's License - State
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Driver's License Number
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Please provide your contact information and address.
Email
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Preferred Phone No.
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Registering for:
(*)
1
1. LTC Class - 80.00 $
2. Veterans and Active Duty - 70.00 $
3. Group Discount – 3 or More Attend Class Together - 70.00 $
4. Cabelas Table Discount - 70.00 $
Total:
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You do not need to have a PayPal account. You can pay with any credit card.
Select method of payment.
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Paypal
Pay At The Door
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