Atlanta Motorcycle Schools’ Application

AMS Sign Up Form (and Gift Certificate)

Please complete and submit the following information. If you are presenting this course as a gift, please fill out the information for the recipient and put your name in the “This is a gift from” section.

After receiving your application, Ken will call you to schedule your session. Call if you have any questions (770.573.9902 business or 678.777.3611 cell).

Please be assured that Atlanta Motorcycle Schools does not share this information with anyone. Information collected in this form is used solely to contact you regarding your motorcycle sessions. Height and weight are requested to assist us in selecting the properly sized motorcycle for your training.

Thanks!

Your Name:

Nickname:
(ie, Bob for Robert)

Address:

City, State, Zip:

Home Phone:

Work Phone:

Cell Phone:

Height:

E-mail:

Weight:

Date of Birth:

Applicants over 65 years of age must provide a letter from their physician. Click here for details.

Yes No

Do you have medical insurance coverage?

Yes No

Can you ride a bicycle?

If you own a motorcycle, what make/model(s)?

If you are already riding, how many miles have you ridden in the past 12 months?

Describe any motorcycle classes you have taken:

Describe any handicaps or physical limitations which might affect your ability to operate a motorcycle:

Describe any medication you take (prescription or over the counter) which might affect your ability to operate a motorcycle:

How did you learn of Atlanta Motorcycle Schools?

This is a gift from (include your address and phone number if the gift certificate is to be mailed to you rather than the recipient):

* All prices are subject to change without notice.

Course Title	Approximate Duration	Cost*	Deposit
Course SB 101 Introduction to Motorcycle Riding	4 hours	$430.00	$200.00
Course SC 102 Introduction to Scooter Riding	4 hours	$430.00	$200.00
Course SB 111 Introduction to Motorcycle/Scooter Riding & Street Skills	5-6 hours	$590.00	$200.00
Course SB 201 Intermediate Rider Skills	4 hours	$400.00	$200.00
Course AS 202 DualSport Riding for the Street Rider	5 hours	$520.00	$200.00
Course SB 301 Street Smarts	6 hours	$520.00	$200.00
Course AS 302 Adventure Sport	6 hours	$540.00	$200.00
2 Course Discount Package (101 & 201) Savings of approximatesly 20%	2 courses	$670.00	$400.00
2 Course Discount Package (111 & 201) Savings of approximatesly 20%	2 courses	$790.00	$400.00
2 Course Discount Package (201 & 301) Savings of approximatesly 20%	2 courses	$750.00	$400.00
3 Course Discount Pkg (101, 201 & 301) Savings of approximatesly 30%	3 courses	$970.00	$400.00
3 Course Discount Pkg (111, 201 & 301) Savings of approximatesly 30%	3 courses	$1070.00	$400.00
Course 501—Scenic Mountain Tours	2 Days	$600.00	$100.00
Course 502—Adventure Tours	2 Days	$600.00	$100.00
Course 503—Ride with Ken	1 Day	$400.00	$200.00

Comments/Questions/Tour passenger name:

Required Gear for all AMS Courses:

DOT Approved helmet (provided, if necessary)
Eye Protection
Full-fingered gloves (preferably leather—provided, if necessary )
Long sleeved shirt or jacket
Long pants (no holes, no tears)
Over-the ankle boots (preferably leather)
Prescription glasses—as required
Rain gear—as required

Mail nonrefundable deposit (check or money order) to:
J K M Inc.
201 Stiles Rd.
Epworth, GA 30541

When your application is received, you will be contacted to schedule your session. Courses 101, 102, 201, 301, and 302 are conducted with one instructor per customer. These courses are conducted Monday through Friday.

Your deposit must be received within five (5) business days to hold your scheduled date.

Three (3) business days notice is required to reschedule any course without loss of deposit.

Validate Input

Please enter “ride2eat” in the box to the left.

Best printed in Landscape mode!

Please note: If you do not see the Thank You page after Submitting, please try again later. If the problem persists, please notify the webmaster. Thanks!

JKM Inc.
201 Stiles Rd
Epworth, GA 30541
(770) 573-9902 (o)
(678) 777-3611 (c)
Email: Ken Murray

Website Designer:
Web Cycle Designs
Email: Webmaster