Safety training course registration

This safety training course registration and supply order form
is to be completed by DNR certified volunteer safety instructors only.

Fill out this DNR safety training registration course form completely in order to schedule your safety program course and receive training program course materials and supplies in a timely manner.

* REQUIRED

Course Registration

* Type of course

Youth Firearms Safety (classroom)
Youth Firearm Safety -- Field Day (for online course)
Adult Firearms Safety Field Day (18 years and older)
Snowmobile Safety (classroom course)
Snowmobile Safety (Online Field Day)
Bowhunter Education (classroom)
Bowhunter Field Day (for online course)
Advanced Hunter Education (classroom)
ATV Safety
Wildlife Species Clinic  

* Instructor Information

Name of instructor: A value is required.

Instructor number: A value is required.

E-mail address: A value is required.

Telephone number: A value is required.

Address:   
Number & Street, RFD, Box No. (NO P.O. BOXES)
A value is required.

City: A value is required.

State: A value is required.

Zip Code: A value is required.

 

* Training Location

Classroom

Location:

A value is required.

County:

A value is required.

Address:
Number & Street, RFD, Box No.

A value is required.   

City:

A value is required.

State:

A value is required.   

 

Zip Code:

A value is required.

Date:

A value is required.   

Time:

A value is required.

* Field Day Or Riding Course

Location:

A value is required.

 

* Class Day

Classes will be held each: (Please select all that apply)

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

 

* Class Dates

Beginning date:
(mm-dd-yy)

A value is required.

Ending date:
(mm-dd-yy)

A value is required.

Time of day:
(hh:mm AM/PM)

A value is required.

Number of classes:
 

A value is required.

Total hours:

A value is required.

 

* Advertise on DNR Webpage

Yes No

Order Supplies

(Note: instructors must keep orders limited to their class size)

* Number of supplies needed (if no supplies needed, enter 0):

A value is required.

Number of exam books needed:
(upon request only)

USB Flash Drive:
(request only for the class you are teaching)

 

FAS Classroom PPT Presentation – USB Flash Drive

Yes No

Snowmobile Classroom PPT Presentation – USB Flash Drive

Yes No

ATV Classroom PPT Presentation – USB Flash Drive

Yes No

Bow Hunter Educ. Classroom PPT Presentation – USB Flash Drive

Yes No

Turkey Clinic PPT Presentation – USB Flash Drive

Yes No

Bear Clinic PPT Presentation – USB Flash Drive

Yes No

 


Additional comments or special request:

 

If you do not see a confirmation page after you submit, please scroll back through the page and fill in any missing information.