Need A Bike Who Are You?*Please select one of the three options below to indicate who you are: > An individual contacting us for yourself > A current partner organization that works with Bikes4Kids > An organization wishing to work with Bikes4Kids as a partner An individual personA current partner of Bikes4KidsA prospective partnerThanks for your interest in Bikes4Kids. As our website states, it is not our policy to give away bikes directly to individuals. We work with social services organizations throughout the Metropolitan area, giving priority to Anoka County. If you have a relationship with a social services organization that can request a bike for you, such as county and state social services, counselors or mental health providers, handicapped and senior assistance providers, participating school services, churches, homeless shelters, etc. I would suggest you contact them to request a bike for you through the website. However, if you do not, you can contact one of our food shelf partners (listed below). They will determine your need and, if you qualify, can request a bike for you. Way of the Lord Food Shelf804 131st Ave NEBlaine 55434Cindy Stokes 763 755 4800 or 612 280 6210jcstks@hotmail.com Manna Market Food Shelf Judy Steven 651 238 7677jamesjudysteven@aol.comYour Name*Name of the person filling out this form. First Last Email*Your email contact Phone*Your primary phone number.Organization*Name of the organization that you represent.Organization Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code WebsiteWebsite of the organization that you represent. Your Mission*Please describe the mission of your organization.Who do you serve?*Who does your organization serve?Type and size of bikes*Do you have a request for specific individual or do you have a generic request for a group of bikes?I have a Specific Request ListI have a Generic List of BikesSpecific Request List*Please fill the list for each individual person as needed based on the following OPTIONS: Gender Options: Enter "B" for Boy and "G" for Girl First Name: First name only Age: Age of the person in years Height: Height of the person in feet' AND inches" Special Notes: If you have a special request for bike type (i.e. BMX, Mtn. Bike, Tagalong, Trike, 3-wheeler, training wheels, color preference or weight considerations) enter them here. We will do our best to honor special requests but there are no guarantees. NOTE - To add a new row to the list click on the symbol next to the "Qty Needed" on the last row. The form is limited to 20 entries max.GenderFirst NameAgeFeetInchesNotes Generic Group Request List*Please fill the list based on type, size and qty of for each type of bike as needed based on the following OPTIONS: Gender Options: Enter "B" for Boy and "G" for Girl Bike Size Options: Trike, 12, 16, 20, 24, 26 NOTE - To add a new row to the list click on the symbol next to the "Qty Needed" on the last row. The list is limited to 12 entries max. GenderBike SizeQuantity Needed Date Needed By* Date Format: MM slash DD slash YYYY Other Question(s)If you have another question please use this text entry for your question and you will hear from one of our coordinators. Share this:Click to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on Pinterest (Opens in new window)Click to share on Google+ (Opens in new window)Click to print (Opens in new window)
