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Go Cycle Bike Loan Scheme - Application Form
Please fill out this application form to register for the Royal Borough of Kingston's Go Cycle Bike Loan Scheme. Once you have finished filling out this form, we will contact you about getting your bike.

Due to the recent high volume of applicants, there is a waiting list of one month. We apologise for this inconvenience, and are trying to do as many loans as possible.

Name and Contact Details
Family Name *
Your answer
First Name *
Your answer
Email Address *
Your answer
Phone / Mobile Number
Your answer
Home Address
Address Line 1 *
Your answer
Address Line 2 *
Your answer
Town / City *
Your answer
Postcode *
Your answer
Personal Details and Cycling Experience
Gender *
Age *
Please note that you must be over 18 to be loaned a bike
What is your approximate height in cm? *
Your answer
How would you describe your current level of cycling experience? *
Do you have any long standing illness (i.e. more than 12 months and likely to continue) or do you have a disability which affects or limits your day to day activities? *
Required
If yes, please provide brief details of your disability
Your answer
Bicycle selection
Please select the type of bike you would like to try: *
Standard bike
Open frame bike
Folding bike
Where will the bike be stored at home? *
If taking the bike to work where will it be stored? *
Will you be leaving the bike at a station? *
What are the main reason/s for loaning a bike? *
Please tick all that apply
Required
Feedback
How did you hear about the scheme? *
Required
Submit
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