FAQ NEWS KY CDWL READING KC3 EVENTS
HOME LEGISLATION SELF DEFENSE GEAR LINKS CONTACT

Kentucky Coalition to Carry Concealed  (KC3)  Membership Application
You can either fill this form out and then print it or print it and fill it out. Once completed, mail it with your check to the address listed below. All information is confidential and for KC3 use only.

Name

Address
Apt. #      City
County   State   ZIP       
Today's Date    Home Telephone   
Work Phone                       FAX   
Email Address
Do you want to be on our email broadcast list for timely information and alerts?   (Check = yes)
Are you a registered voter?                                    Age:
In which Congressional district do you live? 
What is your party affiliation? (Optional)      
Are you a member of the National Rifle Association?   (Check = yes)
Are you a member of GOA or other gun rights organizations?   (Check = yes)

Are you a member of the Kentucky State Rifle and Pistol Association? (Check = yes)

Where (or from whom) did you hear about us?
Individual membership dues, $10 one year    or $25 three years (Check one) 
Household membership Dues, 2 adults of one household and all dependents of each, 
$15 per year.  or $40 three years (Check one) Please attach a sheet listing additional members.
Can you help us at gun shows or in other ways? Please describe:
The following information is optional and is not required for membership.

Occupation   Sex                  Race
Do you have a current KY CDWL Permit from another state?

Signature:____________________________________________________________

Please print this out, sign and send with your check or money order to:

KC3 Membership
PO Box 1269
Frankfort, Ky. 40602