Emergency Bike Bank (EBB) Donation Contact Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

London Bike Hub is establishing a EBB for NHS Frontline and keyworkers in the London Borough of Hounslow. Please use this form if you wish to donate a bike to the EBB Initiative.

Your support of this donation is gratefully received and appreciated.

Email *

Name *

Address *

Phone number *

Bike Make *

Bike Model *

Is the Bike Security Registered..? *

Yes

Is the bike to be donated in reasonable condition and free of major rust..? *

Yes

Other:

Comments about the bike condition

London Bike Hub - Assessment and Evaluation Process

Once this form is completed, London Bike Hub mechanics will access whether your bike is suitable for the EBB initiative and will contact you directly to arrange collection of the bike.

For further information, please contact London Bike Hub at info@londonbikehub.com

Courtesy of London Bike Hub

Send me a copy of my responses.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms