Personal Information

    Your Full Legal Name*

    Your Email*

    Your Address*

    Your Phone Number*

    Your Date of Birth*

    Your California Driver's License #*



    Class information

    Who is your issuing authority?*

    Name as you wish it to appear on your course completion certificate*


    For CCW Applicants Only:
    (please list between 1 and 3 guns to be listed on your completion certificate)

    Please list Make, Model, Caliber, and Serial Number
    First firearm:
    Make
    Model
    Caliber
    Serial#

    Second firearm:
    Make
    Model
    Caliber
    Serial#

    Third firearm:
    Make
    Model
    Caliber
    Serial#

    If you are going through Ripon PD for your CCW, you can add two more guns here:

    Please list Make, Model, Caliber, and Serial Number
    Fourth firearm:
    Make
    Model
    Caliber
    Serial#

    Fifth firearm:
    Make
    Model
    Caliber
    Serial#


    Statement of No Criminal Record, Mental Illness, or Substance Abuse
    By typing my name below, I state that I have no criminal convictions, am not currently under indictment or prosecution for any offense, and am not wanted for questioning or arrest by any law enforcement or government agency. I further state that I have no history of mental illness or substance abuse. I understand that my training may be terminated at any time during the course if my actions are not deemed appropriate by Heida Firearms's staff. I understand that my $75 payment pays for my class and I'll get my certificate emailed to me but otherwise is non-refundablee.

    Type Full Name:*

    By pressing submit you are also agreeing to pay a $75 fee for the CCW Renewal Class.