Texas Department of Public Safety
Request for an Application to Carry a Concealed Handgun
or to Be Certified as a Qualified Handgun Instructor
PLEASE PRINT OR TYPE. ALL INFORMATION MUST BE
PROVIDED
Check all that apply:
__ License Application
__Instructor
Certification
|
| Name: Last, First, Middle |
Date of Birth: month/day/year |
Driver License/State ID Number:
__ DL TX ________________________
__ ID TX ________________________
|
Sex:
__ Male
__ Female
|
Height:
ft. in.
|
Weight:
lbs.
|
Race:
__ American Indian or Alaskan Native
__ Asian or Pacific Islander
|
__ Black
__ White
|
__ Multi-Racial
__ Other
|
Mailing Address:
_____________________________________________________________________
_____________________________________________________________________
City:
________________________________________
State:
_________
Zip: ___________ - ___________ County: ________________________
Phone, Home: (
) _______ - _______________
Business:
( ) _______ - _______________
CR-80 (7/17/95) |