REGISTRATION FORM

   HIGHLIGHT....SELECT...COPY...PASTE... PRINT
TO REGISTER FOR A COURSE, SEND ALL INFORMATION BELOW WITH $50.00 check payable to OTSEGO CO. SHERIFF..
MAIL TO Tim McPherson 3995 Hallock, Gaylord, Mi.49735
( no credit-debit cards accepted)
e-mail iridebmw@freeway.net  Office-231-546-3142/ Cell-989-858-0105

NAME (as on license)_________________________________________________


ADDRESS__________________________________________________________

CITY______________________ZIP_________


PHONE(_____)_____________________________

CLASS (BRC)  (RRC) (ARC)  (CIRCLE ONE)

1ST CHOICE CITY________________ DATE_______

2ND CHOICECITY_________________DATE________

Your email address (print clearly) _______________________________________________
 
Drivers license Number/State __________________________________________________

Date of Birth_____/_____/________

$50.00 CHECK PAYABLE TO OTSEGO CO.SHERIFF
SEND TO :Tim McPherson 3995 Hallock Rd. Gaylord, Mi. 49735
REGISTRATION  IS VOID WITHOUT PAYMENT