Bike Request Sign Up
To make a request, complete the Bike Request form.  Requests will be handled in the order they are received.  When a bicycle that fits your specifications is available, we will contact you and arrangements can be made to have the bike delivered. A new bike helmet will be provided with every bike.  The Good Rural Bike Project.   If you have any questions, please call or text: (415) 859-5176.
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Email *
Wheel size requested? See picture above
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First Name
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Last Name
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Name of School
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Street Address
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City, State and Zip Code
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Phone
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Name of Bike Recipient
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Child's Home Town
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Age
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Gender
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Height *
Weight *
Are training wheels needed?
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Additional information about the recipient
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A copy of your responses will be emailed to the address you provided.
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