CONCEALED CARRY CLASS APPLICATION Date:  _______________ 8:00 a.m. to 5:00 p.m. Location:  Randy's Range 345 Marksberry Ln. Sparta, KY 41086-9575 Instructor:  Mark R. (Randy) Ferguson, KY CCDW certified instructor Phone:  (859) 835-1885 Cost:  $75.00 A deposit of $25.00 is required in advance of the class.  The balance of $50.00 is due the day of the class. Applicants must be 21 years of age or older. This is an 8-hour course with a one-hour lunch break.  Applicants are required to complete both a live firing course of 20 shots for record and a written exam of 25 questions. 1.  Applicants may furnish their own handguns, ammo, cleaning kits, eye and ear protection. 2.  Ammunition must be factory production, no reloads. 3.  Guns should be brought to the class unloaded in a box, case, or holster. 4.  If applicant does not own a handgun, Randy will furnish a .22 target pistol for applicant to use for the class. 5.  Randy will furnish eye and ear protection if needed. Tear off the bottom portion of this application and mail it to the above address along with your deposit.  Please return this form as soon as possible to ensure your place in the next class as space is often limited. ----------------------------------------------------------------------------------------------------------------------------------------------- Please schedule me for the CCDW class to be held on ___________________. Name:  _________________________________________________________ Address:  _______________________________________________________ City:  ________________  State:  ____  Zip:  __________ Phone:  __________