MOTORCYCLE SAFETY MATERIALS ORDER FORM Clear Form

Michigan Department of State
(Rev. 04/2016)
Clear Form
MOTORCYCLE SAFETY MATERIALS
ORDER FORM
Instructions: This order form may only be used by approved Motorcycle Safety Sponsors. Please fill in
all of the requested information including your Rider Education Recognition Program (RERP) number.
Orders without a RERP number will not be processed.
All orders for motorcycle safety materials are shipped via UPS and delivered only to the sponsor’s
business office address. UPS requires a signature when delivering shipments. If no one is available to
accept delivery, it is your responsibility to pick up the shipment at your local UPS office.
Please fax all order forms to the Department of State’s Inventory Services Section at (517) 373-1475, or
email them to [email protected]
Sponsor
Name
RERP
Number
Complete
Address
Contact
Person
Telephone
Number
(
)
AVAILABLE MATERIALS
Quantity
Requested
per Unit of
Issue
Form Name
Form No.
Unit of Issue
Michigan Motorcycle Operator Manual
SOS-116
Pkg
(25 per package)
Motorcycle Safety Palm Card
SOS-423
Pkg
(100 per package)
‘Got your CY?’ Get Your Motorcycle Endorsement
and Stay Safe
OHSP-003
Pkg
(100 per package)
Motorcycle Laws Guide Card
OHSP-006
Pkg
(100 per package)
SOS-401
Pkg
(50 per package)
Motorcycle Rider Safety Certificate of Completion
Inventory Services Section
Richard H. Austin Building – 3rd Floor
430 West Allegan Street
Lansing, Michigan 48918
Phone: (517) 335 - 4793
Fax: (517) 373 - 1475
[email protected]