Norwich e-cargo bike library pre-booking form & survey

Norwich E-cargo Bike Library Pre-Booking Form and Survey

Please complete the pre-booking form and survey below. On completion you'll be taken through to Booqable where you'll be able to select your bike and any accessories and choose a collection date.
The information shared below, as well as location data (GPS tracking of the e-cargo bike, not individuals), will be shared with our funder, Norfolk County Council, and our evaluation partner, the University of East Anglia (UEA) to help us evaluate this project. The General Data Protection Regulation (GDPR) (Regulation (EU) 2016/679) and Outspoken Cycles data privacy policy will be followed. Your data will be treated confidentially.

Please note the e-cargo bikes available through this scheme can only be used within the Norwich Air Quality Management Area (AQMA). The Norwich AQMA can be seen here.
Full Name*

First NameLast Name
Business Name *
Email*
example@example.com
First Line of Business Address*
Business Postcode*
What will your business/organisation use an e-cargo bike for?*
Please give a brief description of your business/organisation:*
How many employees does your business/organisation employ?*
How many employees do you anticipate will use the e-cargo bike during the trial?*
Has your business/organisation used an e-cargo bike before?*

YesNo
Does your business/organisation currently use an e-cargo bike?*

YesNo
If yes, how many e-cargo bikes do you currently have in operation?
How often are they used?

more than once a dayonce a day6 times a week5 times a week4 times a week3 times a week1-2 times a weekfortnightlyless often
How many trips do you make by e-cargo bike in a typical week? (By trip we mean a journey made by one e-cargo bike, from one location, to one or more drop-off/pick-up/service locations).
What is the average distance of one trip made by the e-cargo bike/s in a typical week? (Length in km)
What is the average duration of a trip made by e-cargo bike in a typical week? (Time in minutes)
How many businesses or organisations do you deliver to/collect from/service by e-cargo bike in a typical week?
What is the total electricity cost that you spend on charging your e-cargo bike/s in a typical week? (£, please estimate if not known)
Please add any comments about the above here:
Does your business/organisation currently use a van/car as part of the business?*

YesNo
How many delivery/service vans/cars do you currently have in operation?
How many trips do you make by van/car in a typical week? (By trip we mean a journey made by one vehicle, from one location, to one or more drop-off/pick-up/service locations)
What is the average distance of a trip made by van/car in a typical week? (Length in km)
What is the average duration of one trip made by van/car in a typical week? (Time in minutes)
How many businesses or organisations do you deliver to/collect from/service by van/car in a typical week?
What is the total fuel cost that you spend on deliveries by van/car in a typical week? (£)
It is your responsibility to return the bike on the correct date.*

I understand
At the end of your hire you will be required to complete a rider experience survey and a user experience survey. Please factor in approximately 5-10 minutes to do this when you return the bike to us. The user experience survey will be emailed out after the bike is returned to the business and must be completed. This is a condition required by the council for businesses taking part in the scheme.*

I agree to complete the survey upon returning the bike
After submitting this form you will be taken to our online rental booking page. Although the booking system may allow you to select different days of the week, please only select the displayed days. Please note that if you select a different date to one of these we will have to rearrange your booking.*

I understand
Should be Empty:

Norwich E-cargo Bike Library Pre-Booking Form and Survey