BIKETOWN for All Interest Form

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

BIKETOWN for All is a reduced-cost BIKETOWN membership program for Portland-area residents living on low incomes. Individuals wishing to sign up and pay in cash are required to attend a one-hour workshop that covers how BIKETOWN works and includes a group ride that teaches essential skills for riding a bike in the city. Individuals who have signed up online are welcome and encouraged to attend the workshop and also receive bike safety education materials and a free bike helmet.

Please fill out this form if you are an individual interested in learning about upcoming workshops, or if you are an organization interested in becoming affiliated with the BIKETOWN for All program. See our BIKETOWN for All website to learn more about the program at www.BIKETOWNforAll.org.

Are you... *

A representative of an interested affordable housing provider, social service agency, or local nonprofit?

An individual looking for a BIKETOWN for All membership workshop to join?

Organization:

Are you a member of an affordable housing community, social service agency, or nonprofit organization? Please list them here.

Name: *

Street Address: *

If no street address, you can enter N/A

City: *

Zip Code: *

If no zip code, you can enter N/A

Telephone:

If no telephone or email, please let us know how we can reach you.

E-mail:

If no telephone or email, please let us know how we can reach you.

Do you have a space to host a workshop? *

The space would need to fit 12 people and a BIKETOWN bike.

Yes

What is your availability to host or attend a 1 hour workshop?

Do qualify for or have an Oregon Trail Card? *

Yes

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Community Cycling Center. Report Abuse

Forms