NSSA NSSA Master Level
Instructor Course Application
 
NSSA Number:
First Name:
Middle Initial:
Last Name:
Address 1:
Address 2:
City:
State:
Zip Code:
Cell Phone:
EMail Address:
DOB:
Current NSSA Class:
Highest NSSA Class:
NSSA Registered Lifetime Targets:
How long have you been a Level 3 Instructor?  Years:   Months
How many documented instruction hours do you have AS A LEVEL 3 Instructor*?
      * (must be "clock hours", i.e., 2 hours teaching 3 students counts as 2 hours, not 6 hours)
How many NSSA Youth Camp have you conducted?
How many articles have you published in Clay Target Nation?
 Number of Articles:  Provide Month & Year of the issues:
Course location and date you are requesting:

Cost: $2000.00

Course material will be provided by the instructor

Shooters are responsible for:

  • Submitting a copy of Instructor Journal with all Level 3 instruction hours to the Chief Instructor.
  • Shotgun, ammunition, eye & ear protection, shell pouch or vest.
  • Personal target fees.
  • Equal share of the certifying instructor's travel.
Important:
  • All applicants MUST complete the Background Check Agreement with their application.
  • Enter only the participant's information; use the payer’s only if it’s the same person.

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 NSSA.

I Agree with the above Disclaimer*