Wrench-It-Forward: Repair-A-Bike INDIVIDUAL Scholarship Application
SUMMER 2020: THIS PROGRAM IS NOT CURRENTLY RUNNING DUE TO PANDEMIC. IF YOU SUBMIT AN APPLICATION YOU WILL NOT RECEIVE A RESPONSE.
Email address *
Name (first and last): *
Street Address: *
City: *
Zip Code: *
Phone number: *
Date of Birth: *
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How tall are you? (For bike fitting)
Please describe your race and/or ethnicity in your own words: *
Which Repair-A-Bike course would you like to take? *
Will you be able to attend all 6 sessions of the course? *
If you are unable to attend one of the above listed courses, we may be able to work with your schedule. What days and times are you normally available?
It is not a guarantee that we will be able to accommodate your schedule, but we will if enough other applicants make the same request. If at all possible please select available dates listed on prior question.
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Morning
Afternoon
Evening
What is the main reason you are interested in participating in Repair-A-Bike? *
Would you want to take the course in English or Spanish? *
What is your primary mode of transportation? Walking, bike, RIPTA, Uber/Lyft, driving, other? *
Do you need a bike to get to work? *
Are you currently employed? *
How many individuals are in your household? *
Do you claim anyone as a dependent? *
Does someone else claim you as a dependent? *
What is your household's estimated yearly income? *
Are you a permanent resident of Rhode Island? *
Are you currently attending college classes? *
Do you currently live at home with family? *
Are you a recent American immigrant? *
Are you currently enrolled in a re-entry assistance program (transitioning from incarceration)? *
Are you currently homeless? *
We may not be able to offer full scholarships to all participants. How much (between $0 and $200) would you be able to pay if we can offer you a partial scholarship? *
Is there anything else you'd like to tell us about why you'd be a good candidate for a scholarship? Also include any explanations for previous answers here. *
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