School/Organization Program Request Form

** The All Abilities Bike Program is only available to schools and organizations where a camp format does not align with their structure.

School/Organization Information*

Mailing Address*

Contact Information*

Estimated number of individuals that will learn how to ride a bike annually

Check 'yes' if requesting a standard fleet of (10) 20-inch bikes

Yes

If not requesting a standard fleet, please specify the number of 14-inch bikes you will be needing

(14 inch bike quantities available: 1, 2, 3, 4 or 5. The rest of your fleet will be made up of 20-inch bikes.)

Where did you hear about All Abilities Bike?

Would you like to receive our newsletters?

Yes No

Invoicing Information

Yes No

Social Permission to Share on Social Media?

Yes No

Social Media Links (if applicable}

Please Upload your school/organization's W9

By signing below, I certify that the information contained in this application is true and correct to the best of my knowledge.

Date

School/Organization Program Request Form

School/Organization Information*

Mailing Address*

Contact Information*

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