Call Now To Register! - FDU

RiD E WITH CONFIDENCE!
Call Now
To Register!
800-338-3887
Or Register by
Mail, Fax, or In Person
BY PHONE*
201-692-6500
800-338-3887
BY FAX*
201-692-6505
BY MAIL
Send the registration form along with
check or money order to:
Fairleigh Dickinson University
Office of Continuing Education
1000 River Road, H-DH1-02
Teaneck, NJ 07666
REQUEST PDF FORM*
ridesafe@fdu.edu
*All telephone and fax registrations must
be accompanied by a valid credit card number. No
registrations will be accepted without
payment in full.
FDU is fully approved by the Director of
the Office of Highway Traffic Safety, to
offer the NJ Motorcycle Safety Education
courses.
Please see the other side of this form for
complete registration procedures and policies.
Registrations are not complete without
payment in full.
BASIC COURSE (BRC)
FRIDAY, SATURDAY & SUNDAY
Class Date
March 19-21
March 26-28
April 2-4
April 9-11
April 16-18
April 23-25
April 30-May 2
May 7-9
May 14-16
May 21-23
May 28-30
June 4-6
June 11-13
June 18-20
June 25-27
July 2-4
July 9-11
July 16-18
July 23-25
July 30-August 1
August 6-8
August 13-15
August 20-22
August 27-29
September 3-5
September 10-12
September 17-19
September 24-26
October 1-3
October 15-17
October 22-24
October 29-31
November 5-7
November 12-14
November 19-21
November 26-28
December 3-5
December 10-13
EXTENDED BRC ( E B R C )
FDU
Motorcycle
Program
2 0 0 4 C o u r s e S c h e d u l e
Course No.
42MO0501
42MO0503
42MO0504
42MO0506
42MO0507
42MO0509
42MO0510
42MO0512
42MO0513
42MO0515
42MO0516
42MO0518
42MO0519
42MO0521
42MO0522
51MO0501
51MO0502
51MO0504
51MO0505
51MO0507
51MO0508
51MO0510
51MO0511
51MO0513
51MO0514
51MO0516
51MO0517
51MO0519
51MO0520
51MO0522
51MO0524
51MO0525
51MO0527
51MO0528
51MO0530
51MO0531
51MO0533
51MO0534
3 STUDENTS PER RIDERCOACH
June 18-20
July 16-18
42MO0402
51MO0402
ADDITIONAL RIDING COURSE ( A R C )
I N T E R M E D I ATE LEVEL
May 1
May 19
July 24
42MOI601
42MOI401
51MOI601
BASIC COURSE (BRC) WEEKDAY
WEDNESDAY, THURSDAY & FRIDAY
Class Date
March 24-26
April 7-9
April 14-16
April 21-23
May 5-7
May 12-14
May 19-21
June 2-4
June 16-18
June 30-July 2
July 14-16
July 28-30
August 11-13
August 25-27
September 8-10
September 22-24
October 6-8
October 20-22
November 3-5
November 17-19
December 1-3
Course No.
42MO0502
42MO0505
42MO0524
42MO0508
42MO0511
42MO0525
42MO0514
42MO0517
42MO0520
42MO0523
51MO0503
51MO0506
51MO0509
51MO0512
51MO0515
51MO0518
51MO0521
51MO0523
51MO0526
51MO0529
51MO0532
MONDAY, TUESDAY & WEDNESDAY
May 31-June 2 42MO0401
October 25-27 51MO0401
EXPERIENCED PRACTICE (ERC1)
April 10
April 25
May 2
June 5
July 10
September 19
42MOE601
42MOE602
42MOE603
42MOE604
51MOE601
51MOE602
EXPERIENCED SKILLS PLUS (ERC2)
April 24
May 8
May 18
June 6
June 19
July 11
July 25
September 18
42MOE605
42MOE606
42MOE607
42MOE608
42MOE609
51MOE603
51MOE604
51MOE605
CALL FOR ADDITIONAL DAT E S
Clubs encouraged to apply:
special group rates available!
Basic Course (BRC): $250 (Active NJ Police, EMT & Fire Personnel $225)*
Extended BRC (EBRC): $350 (Active NJ Police, EMT & Fire $325)*
Additional RiderCourse (ARC): $125 (Active NJ Police, EMT & Fire $100)*
Experienced RiderCourses: $125 (Active NJ Police, EMT & Fire $100)*
License is not guarenteed. The State of New Jersey requires that all
participants in the Motorcycle Safety Program have a current and
validated Motorcycle Permit from any state (this includes DMV’s
written test and Eye Examination). NJ residents who successfully
complete the basic course will receive a waiver of the NJ DMV
motorcycle road test. There are no exceptions to this State rule!

Registration and Refund Policy
e m e m b e r !
Payment in full is required at registration. Registration by telephone can only be completed by providing
a valid credit card number. Registration can be made by mail by completing a program application
form and submitting it with a check or money order for the entire amount. FDU reserves the
right to schedule students for alternate class dates than those requested by students on the registration
form. Registrants who refuse the alternate dates will receive a full refund. Registration can
You will need:
be made in person at the FDU Office of Continuing Education in Hackensack, NJ, from 9-5 Monday
through Thursday. Cash payments can be made in person at the Continuing Education Office only
■ Current and validated Motorcycle Permit
during the above hours. DO NOT SEND CASH VIA MAIL. Registration changes or cancellations must
(includes passing the written test and eye
be made NO LATER than five full working days before the start of the course. Tuition, minus a $20
registration fee, will be refunded for cancellation made before this deadline. Non-cancellation
test at MVC), or a valid Motorcycle License
changes in registration made before this deadline will require payment of an additional $25
from any state.
rescheduling fee. ANY REGISTRATION CHANGES OR REFUNDS FOR CANCELLATION AFTER THIS
DEADLINE WILL BE MADE ONLY AT THE DISCRETION OF THE OFFICE OF CONTINUING EDUCATION.
■ Notarized Parental Consent if under 18
years of age.
■ Boots (minimum of one inch above the
ankle, no canvas or cloth).
■ D.O.T. approved Eye Protection.
■ Full-fingered Gloves (preferably leather).
■ Long sleeve shirt or jacket, long pants of
durable material.
■ Rain gear (if necessary). Expect to ride
rain or shine.
■ Snacks or Drinks.
■ Motorcycles are provided for BRC;
helmets are provided for BRC and EBRC.
Classes begin promptly, and students are required to attend all sessions on time. Students can be
removed from the class by the instructors if they are more than 15 minutes late for class. Students
removed from class for tardiness will forfeit their entire tuition and registration fees. No exceptions.
Students without a validated motorcycle permit or license will be removed from the class.
Students who fail to cancel or reschedule their registration prior to the deadline and who do not
attend class, or who voluntarily drop out of the class, or who are removed by the instructor for
either tardiness or safety reasons, will not receive a refund of either their tuition or registration
fees. Exception to this policy is made to individuals with an illness who provide a note from a physician.
FDU reserves the right to cancel classes without prior notice for any reason. Students registered
for a canceled class may either reschedule for a later course at no additional cost, or may opt for a
refund of their tuition and fees.
Registration Form
EMAIL
LAST NAME FIRST NAME M.I.
FOR ADDITIONAL RIDERCOURSE (ARC)
■ Motorcycle license from any state.
■ 1000 miles of riding experience preferable.
■ Your own helmet (DOT approved), and
motorcycle*
■ Riding & safety gear as above.
FOR EXPERIENCED RIDERCOURSE PRACTICE
(ERC1) AND EXPERIENCED RIDERCOURSE
PLUS (ERC2PLUS)
■ Motorcycle license from any state.
■ Your own helmet (DOT approved) and
motorcycle*
■ Riding & safety gear as above.
ADDRESS
CITY/STATE/ZIP
TELEPHONE (DAYTIME) (CELL) (EVENING)
DRIVER’S LICENSE NUMBER
STATE
COURSE DATE COURSE NUMBER ❐ BASIC RIDERCOURSE (BRC) ❐ EXTENDED BRC (EBRC)
❐ ADDITIONAL RIDING* ❐ ERC PRACTICE* ❐ ERC PLUS*
* You will receive the NJ T-CLOCS self–inspection form upon registration; please abide by its guidelines
Please note that this is a physically demanding course.
Do you take any medications that restrict your driving ability, or have any special
accommodation needs (e.g. hearing, reading, learning, or physical disability)?
Yes ❐ No ❐
Is your primary language other than English? Yes ❐ No ❐
If yes, you may bring a translator to facilitate your understanding of the written test.
*Instructors conduct inspections on all
motorcycles. They must have current registration,
insurance and inspection, with fully charged
battery and properly inflated tires with adequate
tread. If, according to MSF and NJ T-CLOCS
standards the motorcycle is in an unsafe state of
repair, the student will not be allowed to
continue with the course, nor will they be
eligible for a refund.
All instructor decisions
regarding safety are final.
PAYMENT METHOD:
Check or Money Order Enclosed ❐
Check Number______________________________
Please charge my credit card: AMEX ❐ VISA ❐ MC ❐
Card Number _______________________________
Expiration Date_____________________________
Signature_____________________________
Send the registration form along with check, money order or charge card info to:
Fairleigh Dickinson University
Office of Continuing Education,
1000 River Road, H-DH1-02
Teaneck, NJ 07666
ridesafe@fdu.edu