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.
Training can be divided into two days.
Fee for NRA Basic Pistol Course (LTC002)
Single student, no other student present, $395.00
Two students, $385.00 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 $225.00. 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 $100.00 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 7/15/06. Make sure and contact
the Instructor before you send in this form with payment in order
to select a training date. Training can be divided into two days.
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
Address: ___________________________________ City:___________________
State: ____ Zip Code: _________________ Phone: (day)_____________________
Phone: (evening) _____________________ (Cell Phone) _____________________
Email Address:________________________________
NRA Member? Y / N (circle one) NRA Member # ___________
GOAL Member? Y / N (circle one) GOAL Member # __________
How did you find out about my training? Circle appropriate response:
(Web Site) ( Police Dept.) (Word of Mouth) ( Mass State Police)
(GOAL)
(Firearms Store) (Other ______________)
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