first aid interest | Aubrey Mitsch Fndn

First name

Last name

Email

Phone

How long have you been riding a motorcycle?

Have you previously completed a motorcycle safety course?

Yes

No

Prefer not to answer

Have you previously completed First Aid or CPR training?

Yes

No

Not sure

Prefer not to answer

Have you ever provided First Aid during a motorcycle accident or other emergency?

Yes

No

Prefer not to answer

What is your current military service status?

Currently serving — Active Duty

Currently serving — National Guard/Reserves

Veteran — not currently serving

No military service

Prefer not to answer

What days would you be most likely to attend a motorcycle First Aid training course?

Select all that apply. If you select “No preference” or “Flexible,” you do not need to select another option

How far would you be willing to travel to attend a motorcycle First Aid training course?

Would you be interested in attending a training session with other riders you know?

Yes

No

Maybe

Prefer not to answer

What interests you most about this training?

Yes, please contact me about future motorcycle safety and First Aid training opportunities.

By providing your information, you agree that the Aubrey Mitsch Foundation may contact you regarding future motorcycle safety and First Aid training opportunities. Your information will not be sold or shared with third parties for their marketing purposes.