D15 Bike Library - Sign Up Form

Please complete the form below to apply to participate in The D15 Bike Library.

Borrow an e-bike free for 3 months and experience how cycling can fit into your daily routine. Whether you're commuting to work, doing the school run, or running errands, the Bike Library gives you a chance to try out a practical, low-cost alternative to car travel. There’s no rental fee involved, just a fully refundable deposit which is returned to you at the end of the loan period.

Bike Number

Name

First NameLast Name

Email Address

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Address

Street Address

Postal / Zip Code

What is your relationship to the D15 Bike Library

What is your current mode of transport?

What is the distance you cover each day as part of your regular daily routine?

Where do you regularly travel on a typical day(Select all that apply)?

What type of bicycle storage space do you have in your home? ( Select all that apply)

Do you require an e-bike to carry a child/children?

What age is your child?

Rows	Under 2 yrs	2-5yrs	5+yrs
Child 1
Child 2
Child 3
Child 4

Tell us why you would like to participate in the Bike Library?

What type of bike would you prefer to borrow? (We cannot guarantee that you will receive your first preference, and the exact model may not match the pictures shown below.)

2nd preference?