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Date of Birth
Sex	Male Female
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Physical Build	Small Average Large
Physical Challenges	Yes No
Please Describe
Current Motorcycle License?	Yes No
Do you own a bike?	Yes No
(If so what kind?)
Previous Riding Experience?	Yes No
If so please describe your Experience
How many years riding?	1-5 6-10 10+
Ever take a Motorcycle Rider Course?	Yes No
If so, Where and When?
Need Motorcycle Gear?	Yes No
Type of riding