Training Application | New Jersey Firearms Academy

Name *

First

Middle

Last

Email *

Address *

Address Line 1

City

State

Zip Code

Home Phone

Work Phone

Cell Phone

Date of Birth *

Place of Birth

Are you a U.S. Citizen? *

Yes
No

If 'No' what is your residency status?

Gender

Male
Female

If you are or may be pregnant, we strongly recommend you refrain from shooting.

Have you ever been convicted of a crime?

Yes
No

Might you have any outstanding warrants?

Yes
No

Have you ever been convicted of any domestic violence in any jurisdiction?

Yes
No

Have you ever had a firearms license or permit refused or revoked?

Yes
No

Have you ever been hospitalized for a mental reason?

Yes
No

Do you use a narcotic or other controlled substance?

Yes
No

Do you have any condition that may make it hard to use a firearm?

Yes
No

What courses are you interested in? Please indicated Date/Time

Referred by

How did you hear about us.

Confirmation or Voucher Code

Which site did you purchase this voucher?

Do you have any health or physical concerns that may effect your ability to do physical activity, or require special accommodation?

Yes
No

Additional Comments

If you are applying for Advanced or Security training, please complete the below questions. If you are NOT, skip to the bottom to complete the Anti-Spam verification and press 'submit'.

Will you consent to a background investigation?

Yes
No

Will you have medical clearance to participate in related physical activities?

Yes
No

Height (Ft. - In.)

Weight (Lbs), please enter your weight in pounds

Eye Color

Hair Color

Do you currently have medical coverage?

Yes
No

Highest level of education?

HS / GED, 2 year degree (Associate)
4 year degree (Bachelor)
Graduate Degree (Masters)
Post-Grad (Ph.D, J.D., M.D., etc.)

What (valid) certifications do you currently hold?

What (valid) certifications do you currently hold? (others)

Are you currently working in security, or a related field?

Yes
No

Your blood type (if known)

Please list any allergies, including dog, if any:

Do you hold a valid driver's license?

Yes
No

Any medical condition of concern?