Request a Bike
If you are a part of a local organization and have identified a resident of Santa Cruz County who is in need of a bike, please fill out this form and we will do our best to match that individual with a suitable bike.  We will do our best to fulfill requests 3 times throughout the year.  Our goal is to give bikes away the first week of December, April and August.
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Email *
What is the name of your organization? *
Phone Number of person within the organization requesting the bike. *
First name or alias of individual in need of a bike
What type of bike would you prefer?
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Bike Sizing
Select size of bike requested based on size chart above *
Age of Individual *
Height of Individual *
Please tell us a little bit about the individual or include a note from the individual stating why they would like a bike. *
Submit
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