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Bicycle Repair Station Interest Form
Welcome to the City of Los Angeles Bicycle Repair Station Interest Form. Please provide the following information so that we may compile a list of interested parties and begin planning for Bicycle Repair Stations in your neighborhood.
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* Indicates required question
Name of Business
*
Your answer
Type of Business
*
ie. Restaurant, market, coffee shop, retail store, etc.
Your answer
Address of Business
*
Address Street City State Zip Code
Your answer
Council District
*
find your council district by using the link provided:
http://bicyclela.org/maps_main.htm#lamaps
CD 1
CD 2
CD 3
CD 4
CD 5
CD 6
CD 7
CD 8
CD 9
CD 10
CD 11
CD 12
CD 13
CD 14
CD 15
Business Owner or Contact Name
*
Your answer
Phone Number
*
###-###-####
Your answer
Email
*
Your answer
LADOT Contact
If you have already spoken to someone at LADOT, please let us know
Your answer
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