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Bike Loan Scheme
The Green Hope Cycling Project
London CC CIC ( London Cycling Club )
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Name and Surname *
Phone number *
Email *
Do you live, work or study in Edmonton, you can apply for this project. *
Qualifying Address ? *
Age *
Gender *
What is your approximate height ? *
What purpose will you mainly use the bicycle for ? *
Select how long do you want to borrow the bike for ? *
Ethnicity *
What language do you speak other than English  ? *
Do you have any medical conditions we should be aware of ?
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If yes please state your medical condition here
Current cycling standard ? *
How confident do you feel about riding on the road ? *
If you receive a bicycle and cycle training from us, how often do you intend to cycle ? *
What difference it will make to your life if you receive a bicycle and cycle training from us *
Required
Where will the bike be stored at home ? *
Do you receive any welfare benefits ? *
Do you need a child bike seat ? *
Do you work ? *
If yes how much is your yearly income ?
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How did you find out about our community cycling project you are applying for ? *
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