Contact Information
Name of Organization
*
Please Select
70x7 Life Recovery
A Place for Now
Alpha Grand Rapids
Arbor Circle
AYA Youth Collective
Bethany Christian Services
CarePortal
Catherine's Health Care
Church World Service
Community Rebuilders
Dégagé Ministries
The Delta Project
Dwelling Place
Exodus Place
Family Outreach Center
Family Promise of West Michigan
Friends of Grand Rapids Parks
Grand Rapids Police Dept. C.L.E.A.R.
The Grand Rapids Red Project
Grand Rapids Trans Foundation
Guiding Light
Health Net of West Michigan
HELP Pregnancy Aid
Hero's Corner
Hope Network
Indwelling Community Church
Matthew's House
Mel Trotter Ministries
Michigan Department of Corrections
North Kent Connect
Our Hope Association
Pediatric Oncology Resource Team (P.O.R.T.)
Pine Rest Christian Mental Health Services
Puertas Abiertas
Refugee Education Center
The Right Door
Ronald McDonald House Charities West Michigan
Safe Haven Ministries
Samaritas
Senior Neighbors
The Source
Steepletown Neighborhood Services
Sunshine Community Church
Treetops Collective
Ukrainian Society of Michigan
Urban Family Ministries
Wedgwood Christian Services
Women's Resource Center
YWCA of West Central Michigan
Zero Day
Requester Name (You must be a staff member at one of our partner organizations to request a bike)
*
First Name
Last Name
Requester Email (Please use staff email)
*
Confirmation Email
example@example.com
Requester Phone Number
*
Please enter a valid phone number.
How many bikes are you requesting?
Specify how many bikes of each size are needed.
Adult Small
Rider is under 5'6" tall
Adult Medium
Rider is 5'6" to 5'9" tall
Adult Large
Rider is 5'10" to 6'1" tall
Adult X-Large
Rider is over 6'1" tall
Bike Pick-Up Appointment
Pickup is available during open hours Monday-Thursday from 10 am to 4 pm. Please select the available date and time that works best for you. We appreciate you coming during your selected time, but if for some reason you are unable to pick up as scheduled, we will hold the bike(s) requested for three business days before we need to put them back into inventory.
*
*
I will complete the Rider Data Collection Form for each bike I am requesting.
Please verify that you are human
*
SUBMIT
Should be Empty: