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				*Northwest Survival Skills, LLC* *Sniper Challenge Registration*



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To register for the 2010 Oregon Sniper Challenge, please fill out the form below.

The information provided to us on this form is used for registration purposes for course only. No information from this form is provided or sold to any other entity for marketing or other purposes.

Please fill out this form completely then click on the "submit" button at the bottom of the form. If you wish to print a copy of the form for your records click on the "Printer friendly" button at the bottom of the form PRIOR to filling in the form and clicking submit. This will allow you to fill out the form in a format which will allow you to more easily print it out, then simply click on the "Submit" button while still in the printer friendly version of the form to submit your registration.

Registration information:

First name:

* required

Last name:

* required

Rank:

Email address:

Phone #:

Agency/Company:

* required

Mailing address:

Billing/Payment Information:

Method of payment:
(Must select one)

P.O. # (If applicable):

*** All payments for registration must be RECEIVED by April 01, 2010! If payment is not received by 04/01/2010, registration may be vacated and given to the next person who is on "stand by". We will only accept payment at the door by prior approved special arrangement, or if a verified purchase order is issued! Cancelations after 04/01/2010 are subject to a charge of up to the full registration fee.***

Billing Address:

Billing Attn:

Northwest Survival Skills, LLC * P.O. Box 2228 * Clackamas * OR * 97015 Phone: (971) 570-2284 Fax: (503) 668-1362