American Combat Evolutions

Course Offerings:

Course *	Empty Hand Combat \| Islip, NY \| 3/12/22
First Name *
Last Name *
Street Address *
City *
State *
Zip *

Primary Number *
Secondary Number
Email Address *

Agency/Organization
Firearm & Caliber
Agency Address
Agency Phone
Civilian Permit Holders	(Required for all pistol courses!)
Pistol Permit Type
Pistol Permit #
Permit Issuing Authority

Comments
I swear & affirm that I can legally own, use and possess a firearm in the United States of America.