Brisbane West Bicycle User Group membership signup form
Membership type *
Family membership only - how many people in your family?
Number of people in your immediate family (if selected family membership type)
First Name *
Surname *
Sex *
Email address *
Mobile number *
Can we contact you via text message for petitions, campaigns and events relating to your suburb? *
Alternate phone number
This is optional. Input an alternative number such as home or work phone number.
Street number
Providing your street number is optional.
Street Name *
Suburb *
How would you describe your interest and level of confidence in cycling? *
Pick the option most relvant to you.
Check all that apply. Reasons I ride a bike: *
If you have selected a family membership, select reasons that apply for any family member.
Required
What specific bike routes/issues in your local area do you want addressed by Brisbane West BUG? Which suburbs? *
What other cycling-related issues do you want addressed by Brisbane West BUG?
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