Preliminary Information Form for Conceal Carry & Home Defense Instructor Candidates Are you at least 21 years of age? * Yes No Name * First Name Last Name Email * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Twitter If you do not have a personal Twitter account, please leave blank @ Facebook URL * If you do not have a personal Facebook account, please put N/A Website http:// Firearms Experience * Professional, Recreational, Certifications (past or current) Teaching Experience * Professional, Volunteer, etc. Why do you want to have this certification? * Thank you for your interest in our CCHD Instructors course. You will be contacted after your initial application review.
