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| NSCA Number: |
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| First Name: |
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| Middle Initial: |
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| Last Name: |
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| Address 1: |
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| Address 2: |
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| City: |
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| State: |
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| Zip Code: |
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| Cell Phone: |
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| EMail Address: |
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| Current NSCA Class: |
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| Highest NSCA Class: |
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| NSCA Registered Lifetime Targets: |
| How long have you been a Level I Instructor? Years:
Months
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How many documented instruction hours do you have AS A LEVEL I Instructor*?
* (must be "clock hours", i.e., 2 hours teaching 3 students counts as 2 hours, not 6 hours)
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| Have you ever taken lessons from a Level II or equivalent sporting clays instructor before:
Yes
No |
| If so, from whom: |
Total # Hours? |
| Where / When ? |
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| Course location and date you are requesting: |
Costs:
$750.00 (Three day course).You will also be responsible for the following additional costs: your
personal target fees at the host club, the certifying instructor's expenses (each candidate will pay an equal share of the certifying instructor's
expenses).
Please bring: Shotgun, 250 rounds of ammunition, eye protection, ear protection, shell pouch and/or vest, three-ring binder (for handouts) and
printed course manual (on-line). Please go to
Instructor Suppport Materials (opens in a new window),
and download the Level II Instructor Manual to study.
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Note: It is very important that you enter the information of the person that is signing up for the course, not the contact information of the person paying (in many cases, this will be the same person).
Also note that while we receive notification of payment immediately, there is still processing that must take place in our office before your applicaation is completed.
This process can take up to 10 business days.
Falsification of the above information will result in disqualification and the return of all prizes and monies for all events. Falsification of classification information could also lead to suspension from the NSCA.
I Agree with the above Disclaimer*
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