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WOC Bike Program:  Application 
You can return to the WOC Bike Program page by clicking here.

Welcome to the Application page for the WOC Bike Program.  Before submitting the application below, please read and consider the following.  Do you meet the following qualifications?  1. I want to begin using a bicycle for more of my day-to-day transportation around town, either for financial or ethical reasons.  AND 2. I do not have a reliable bicycle.  AND 3. I cannot afford a reliable bicycle.  OR 4. I can probably afford a bicycle, but cannot justify the cost.  BUT NOT 5. I only want to use a bicycle as a last resort until I can afford to drive my car everywhere again.  If you meet these qualifications, please continue on to the application below!  (Please note:  At this time, we are only able to serve the Colorado Springs, Colorado, area.)

Copy and paste the following application into an email.  Fill out the blanks in your email program, then send the completed application to us at info (at) wheelsofchange (dot) net (it's spelled out like that so spammers can't use it).  Please answer all questions with complete honesty - we are not necessarily looking for the types of answers you may assume we are.

1. Name:

2. Age:

3. Address:

4. Email address:

5. Phone number:

6. Occupation:

7. Approximate monthly income:

8. Approximate distance from home to work:

9. Do you currently have a car?

10. If so, what is your average monthly gasoline cost?

11. Do you currently have a bicycle?

12. Have you ever ridden a bicycle for transportation on a regular basis?

13. Why are you interested in riding a bicycle for transportation?  Please be detailed.

14. Would you be willing and able to provide WOC with occasional updates on your riding for transportation?

15. Would you be willing and/or able to make a donation, however small, to the WOC Bike Program?

By submitting this application, you agree that, if selected, we may use your name and likeness in conjunction with Wheels Of Change's WOC Bike Program, as well as other Wheels Of Change programs and projects.  You also agree to provide us with occasional updates on how your riding for transportation is working for you.  If, should you receive a bike from Wheels Of Change, you find that the bike does nothing but sit in the garage while you continue to drive around for most transportation, you agree to return the bike to WOC for use with another, more motivated rider.

You can return to the WOC Bike Program page by clicking here.

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