Moto Application Please fill out the entire application to the best of your ability. Have you ever applied to the program before? YES NO First Name Last Name Mailing Address Shipping Address City ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWYBCABSKMBONQCNSNBPENLNTYTNU Zip/Postal Code Cell Phone Home Phone E-mail Fax Age Racer # When did you start racing? What district do you compete in? What state/province do you compete in? What type of racing do you participate in? Motocross Hill Climb Freestyle Enduro/Off Road Oval/Dirt Track Side By Side ATV BMX Other What class did you participate in last year? What class(s) do you plan to participate in this year? How many years have you been competing at your current skill level? Career Highlights Current Sponsors What type of machine(s) do you own/race? Bike ATV Please specify stroke engine 2 Stroke 4 Stroke Please specify engine cc 50cc65cc85cc125cc250cc450cc500cc+Other List 10 different race events you attended in 2017 - 2018 season, your place of finish and or/year end points position Race Location Class Association Class Raced Place of Finish List overall series results from the past two race seasons. Jersey Size YS (6)YM (8)YL (10-12)YXL (14)SMLXL2XL3XL4XL Pant Size 2224262830323436384042 Glove Size 3XS2XSXSSMLXL2XL Attach your resume here Terms I understand that my acceptance on the race program means that I will be using my machine for competition purposes in a safe and professional manner. I hereby verify that the proceeding information is true and correct; falsifying any information may cause immediate disqualification from any FXR Racing Inc. support.