Go Cycle Bike Loan Scheme - Application Form
Once you have completed this form to register for the Go Cycle Bike Loan Scheme. we will contact you as soon as possible about getting your bike.

If you can see a 'REQUEST EDIT ACCESS' message above this form, please ignore it - you do not need to 'edit' the form, simply complete and submit it.

NB. Your completed form and its contents ONLY be used for the purpose of processing your booking for the Bike Loan Scheme unless you agree to participate in the User Survey.
User survey *
The Royal Borough of Kingston is working with Kingston University to conduct a survey of the GoCycle Bike Loan Scheme to help us improve our services. As a user of the Bike Loan Scheme we would like to ask if you would agree to Kingston University contacting you to ask about your experience the Cycle Loan Scheme as part of this survey.
Required
Name and Contact Details
Family Name *
Your answer
First Name *
Your answer
Email Address *
Your answer
Phone / Mobile Number
Your answer
Home Address
Address Line 1 *
Your answer
Address Line 2 *
Your answer
Town / City *
Your answer
Postcode *
Your answer
Personal Details and Cycling Experience
Gender *
Age *
Please note that you must be over 18 to be loaned a bike
What is your approximate height in cm? *
Your answer
How would you describe your current level of cycling experience? *
Do you have any long standing illness (i.e. more than 12 months and likely to continue) or do you have a disability which affects or limits your day to day activities? *
Required
If yes, please provide brief details of your disability
Your answer
Bicycle selection
Please select the type of bike you would like to try: *
Standard bike
Open frame bike
Folding bike
Where will the bike be stored at home? *
If taking the bike to work where will it be stored? *
Will you be leaving the bike at a station? *
What are the main reason/s for loaning a bike? *
Please tick all that apply
Required
Feedback
How did you hear about the scheme? *
Required
Submit
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