Request a bike

Name(Required)

First Last

Email(Required)

Person/organisation you are applying for a donation of bike (s) for?(Required)

How are you involved with this organisation/ individual?(Required)

Number of bikes requested?(Required)

What type of bikes are you looking for?(Required)

Please add any further details you think are relevant to help us when considering your request for a donation of refurbished bikes. e.g. how will the bike donation make a difference to the person receiving it(Required)