Membership Application Form


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Dear Friend,

Great! I'm glad you've decided to join U.S. Concealed Carry. Here is some feedback from a member who recently joined our community.

Member Testimonial

Dear Tim,
I am writing to express my complete satisfaction with U.S. Concealed Carry. I find your no-nonsense, real world focus, to be a refreshing change. I found the CCM Profiles to be especially good. It was great to see other concerned citizens speaking out on CCW matters. It makes the rest of us feel less like "gun nuts" and more like a community of concerned and squared away citizens.
Keith Robb
Cuyahoga Falls, OH

And don't forget, our internet order form uses 128-bit SSL encryption, so your personal and credit card information is 100% secure. Your membership is also backed by our "Bullet-Proof" Satisfaction Guarantee.

Secure Membership Form

We respect your privacy. The personal information requested below is for use in processing your credit card, which is done with secure encryption. We never reveal, share, or sell member information. For complete details see our Privacy Statement.

Customer Information

* = Required - Must match credit card billing address!

First Name [ required ]
Last Name [ required ]
Company
Address Line 1[ required ]
Address Line 2
City [ required ]
State [ US & Canada ]
State/Province [ All other Countries ]
Zip/Postal Code [ required ]
Country [ required ]
Your E-mail Address [ required ]
Phone or Fax Number [ required ]

Shipping Information

Shipping same as billing address

Ship To First Name [ required ]
Ship To Last Name [ required ]
Ship to Company
Ship to Address Line 1[ required ]
Ship to Address Line 2
Ship to City [ required ]
Ship to State [ US & Canada ]
Ship to State/Province [ All other Countries ]
Zip/Postal Code [ required ]
Ship to Country [ required ]

Membership Options

Membership Plan:	1 Year FULL Membership ($69.00/yr.) Save Over 15%! You will be charged only one time and will not be automatically renewed. 1 Month FULL Membership ($6.97/mo.) with convenient Automatic Renewal. Your credit card will be charged automatically every month (31 days). You can easily cancel any time! 1 Year Magazine ONLY ($39.00/yr.) You will be charged only one time and will not be automatically renewed. This option does NOT include access to website content.

Choose LOGIN Name [ required ]

Choose PASSWORD [ required ]at least six characters long, using alphas and numbers, no spaces.

Confirm PASSWORD [ required ]

Payment Information

Payment Method [ required ]
Credit Card Number [ required ]
Credit Card Security Code [ required on (MC/Visa/AMEX/Discover) ? ]
Expiration Date [ required ]	/
Name on Credit Card [ required ]
Is this a Renewal?
Do you wish to receive email alerts?
<<< Please Check The Box to acknowledge that you have read and understood our terms of use.


NOTE: It can take up to a minute to process the credit card information and obtain approval. Please do not press the submit button multiple times - doing so could cause double billing.
For the protection and privacy of our visitors and customers, as well as the security of the server, suspicious activities on our site are monitored, tracked and reported.