Earn-a-Bike Application

You may save your partially completed application and return later, if desired.

    
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What is a trip?
A trip is any time you leave from and return to a place.
  • A trip from your home to your work and then back home is one commute trip.
  • If you bike to work, bike to the grocery store during lunch, bike home from work that would be one errand trip and one commute trip.
  • If you ride your bike for exercise and start and stop in the same place (riding in a loop or out and back), that is one fitness trip.
1. Tell us about your current bicycling habits*:
  • Commute to work?    
    • How many trips per month?
    • How many miles per trip?
  • Commute to school (yours or your child's)?    
    • How many trips per month?
    • How many miles per trip?
  • Errand Trips (e.g. shopping, doctor appointments)?    
    • How many trips per month?
    • How many miles per trip?
  • Social & Family Fun Trips (e.g. to park, friend's house)?    
    • How many trips per month?
    • How many miles per trip?
  • Fitness?    
    • How many trips per month?
    • How many miles per trip?
2. Tell us how participating in this program will change your bicycling habits*:
  • Commute to work?    
    • I pledge to make trips by bicycle per month
  • Commute to school (yours or your child's)?    
    • I pledge to make trips by bicycle per month
  • Errand Trips (e.g. shopping, doctor appointments)?    
    • I pledge to make trips by bicycle per month
  • Social & Family Fun Trips (e.g. to park, friend's house)?    
    • I pledge to make trips by bicycle per month
  • Fitness?    
    • I pledge to make trips by bicycle per month
3. Explain why you are interested in participating in this program and how you plan to utilize your new bike.*
4. Can you replace car trips with bike trips? How will this impact your life?*
5. How would you rate your experience level?*
       


Have you previously taken any bike education courses? If so, what class and when?*

6. What part of the course are you most interested in? Bike maintenance, bike handling, traffic skills, or something else?*
Program Agreement
  • I certify that I am participating in this program for my own benefit and to reduce car trips.
  • I agree to complete two follow-up surveys.
  • I agree to maintain my contact information and/or notify North Natomas Jibe if any of my contact information changes.
  • I understand completion (by attending ALL sessions in full) of the 14-hour course is required to receive a bicycle voucher. Course is held at Inderkum High School (2500 New Market Drive).
    • Saturday, April 6, 2019, 9 am – 2 pm
    • Tuesday, April 9, 2019, 5:30 – 8:30 pm
    • Tuesday, April 16, 2019, 5:30 – 8:30 pm
    • Tuesday, April 23, 2019, 5:30 – 8:30 pm
  • I have read and agree to comply with the program guidelines.

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