1 Start 2 Complete First Name * Middle Name Last Name * Date of Birth * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year19231924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023 Phone Number (Numbers Only) * E-Mail License Application Type * - Select -Firearms Identification CardLicense to CarryLicense to Possess a Machine Gun Check One * New Applicant Renewal If Renewal Applicant - Most Recent LTC/FID Number * If Renewal Applicant - City/Town Most Recent License Was Issued * If Renewal Applicant - Date of Expiration of License * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year201320142015201620172018201920202021202220232024 Preferred Appointment Time 10 a.m. 1 p.m. No Preference Notes or Additional Information
