Resources

Boston / Brookline Residents

Click Here to download the Application Form or Print the below text.

Complete the application, and return it along with your check in the full amount to

Lynne Roberts, P. O. Box 66248, Auburndale, MA 02466.

The course fee covers use of firearms, ammunition, eye and ear protection, and all training materials. All courses are taught as private lessons. No experience is necessary. Upon receipt of payment and registration form, a textbook, additional course materials, and a set of driving directions will be sent to you. Any cancellations must be made no later than one week prior to the course date. No refunds are available; but you may reschedule the course for another date. You can also contact Lynne Roberts via e-mail from this web site or by calling (781) 799-8156. Make sure and talk with the Instructor before you send in this form with payment in order to select a training date. All training is done in a non-smoking environment. Individual/Small Group Training can be divided into two days.

Fee for NRA Basic Pistol Course (LTC002)
Single student, no other student present, $175.00
Two students, $150.00 each

Fee for a Moon Island Practice Session.
Practice session includes: a thorough review of the fundamentals of shooting a pistol, firearms safety rules and procedures, and the practice session using the requirements of the Moon Island Range Test. The fee is $100.00. This includes: range time, eye & ear protection, targets, ammunition, and firearm. The entire session is about 2 hours.

Fee for Administering the Moon Island Range Test (no practice session)
The fee is $150.00. This includes: range time, eye & ear protection, target, ammunition, and firearm.. The entire session is about 1 hour.

Moon Island Fee for Students Already Taking the NRA Basic Pistol Course (LTC002)
If you are taking the NRA Basic Pistol Course and want to include a practice session for the Moon Island Test (or in the case of Brookline residents, practice and then have the Test officially administered to you) there is a fee of $50.00 in addition to the cost of the NRA Basic Pistol Course (LTC-002).

Payment, in full, along with a completed registration form, is due before the beginning of class, practice session or shooting test. These fees are current as of 1/1/2009. Please be sure to contact the Instructor before you send in this form with payment in order to select a training date.

Safety Rules & Release
By completing this application, you are agreeing to abide by all Safety Rules established by Lynne Roberts, and to sign a Release of Liability for any injuries you may sustain during the course of training.

Complete All Information Below

Preferred Date(s): ___________________ Enclosed Fee: $__________

Are you: Right-handed? Left handed? (circle one)

Do you wear glasses? ____________ Do you wear bifocals? _____________

State your prior experience, if any, with firearms (no experience necessary):

Do you have any physical impairments that would make training more difficult:

Name: ________________________________________________________

Date of Birth ______________ Sex: M / F

Street: _____________________________________________________

City:___________________ State: ____ Zip Code: _________________

Best Phone:__________________ Alt Phone_________________

Email Address:________________________________

NRA Member? Y / N (circle one) NRA Member # ___________

GOAL Member? Y / N (circle one) GOAL Member # __________

SAS Member? Y / N (circle one) SAS Member # _________

How did you find out about Pistol Safety Assoc/Lynne Roberts?

(Web Site) ( Police Dept.) (Word of Mouth) ( Mass State Police) (GOAL)
(Firearms Store, which one__________) (SAS) (Other ______________)