eBikes for Borderers - Booking Request Form
Our project is funded by South East Scotland Transport Network (SEStran) which enables us to provide you the opportunity to try out an ebike free of charge. To make a booking for an ebike with us please answer the questions below. 
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Email *
First Name *
Surname *
Height *
How tall are you?
Postcode *
What is your postcode?
Address *
What is your full postal address (House number / name, Street, District, Postal Town)
Phone Number *
What is your phone number?
Style of Bike *
What style of bike would you prefer to trial?

The Raleigh is a step-through bike which is easier to get on and off. This bike is for road use only.

The Cube is a hybrid bike, giving the option for light off road use if needed. This is NOT a mountain bike and must not be ridden as such. 

The Specialized is a step-through hybrid bike, easier to get on and off and giving the option for light off road use if needed. This is NOT a mountain bike and must not be ridden as such. 

Is this your first time hiring a bike from eB4B? *
Return Agreement *
We offer free trials for a minimum of 4 weeks (sometimes longer) with a fixed date and time for collection and return which we will tell you once we receive your form and allocate you a bike. We employ someone for one day a month to manage collections and returns and we do not have funding to be flexible about this. If we give you a bike to trial it is on the understanding that you will collect it and return it on the dates we give you, and that you will notify us in advance of collection if those dates don't suit so that we can offer a bike to someone else. If, once you have the bike, you are unable to return it on the agreed return date we have no option but to  charge £25 for a one off return appointment to cover the costs of us paying a team member to attend. Please confirm below your acceptance of these terms.
Proof of Id *
Before we give you a bike we will need to see a form of Photo ID and proof of address such as a recent council tax bill, or utility bill. Are you agreeable to this?
Deposit *
Once we have allocated you a bike and agreed collection and return dates, we will require you to pay a deposit of £50 to secure the booking. This will be refunded in full at the end of your trial provided you bring the bike and all accessories back in clean and undamaged condition. The costs of any loss, damage or cleaning will be deducted from your deposit and you may be invoiced if the costs come to more than this amount. Please click Yes below to acknowledge your acceptance of this.
Where did you hear about ebikes 4 borderers? *
We are required to ask you to complete a survey before and after your trial of the bike as a condition of the funding from South East of Scotland Transport Partnership. This is so that they can gather information on people's usual modes of transport and preferences as input to strategic plans for Transport Scotland.

Are you willing to answer the questions and to complete a post-trial questionnaire to enable us to offer you this free trial?
 *
How do you usually travel to work? *
How often do you use each of the following modes of transport to travel to work? *
Never
Not in the last year
Once or twice a year
Monthly
Fortnightly
1 or 2 times a week
3 or 4 times a week
5 or 6 times a week
Everyday
Walking or wheeling
Driver car/van
Passenger car/van
Bicycle
Bus
Rail
Taxi/ mini cab
Other
How likely are you to consider cycling more of a means of transport ( i.e for a specific purpose to reach a destination) in the future? *
Which one of the following statements best describes you? Would you say you are someone who... *
How would you most like to travel to work? *
How often do you cycle for pleasure/exercise? E.g. just
“going for a cycle” rather than to a destination? *
To what extent do you agree or disagree with the following statement?
"I feel safe cycling" *
What discourages you from cycling to work?
Select all that apply *
Required
Which of the following, if any, would encourage you to cycle to work?
Select all that apply *
Required
How do you usually travel for journeys under 5 miles? *
How often do you use each of the following modes for
journeys under 5 miles? *
Never
Not in the last year
Once or twice a year
Monthly
Fortnightly
1 or 2 times a week
3 or 4 times a week
5 or 6 times a week
Everyday
Walking or wheeling
Driver car/van
Passenger car/van
Bicycle
Bus
Taxi/mini cab
Rail
Other
How likely are you to consider cycling more as a means of transport (i.e. for a specific purpose, to reach a destination) in the future? *
How would you most like to travel for journeys under 5
miles? *
What discourages you from cycling more than you do for journeys under 5 miles?
Select all that apply *
Required
Which of the following, if any, would encourage you to cycle more often for journeys under 5 miles?
Select all that apply *
Required
Age *
Which age group do you belong to? (tick one box)
Gender *
What best describes your gender?
Ethnic Group *
What is your ethnic group?
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