Street Collective Bike Share Scholarship Form

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Our bike share scholarship program is designed to give low-income individuals access to active transportation and recreation options. All applicants need the sponsorship of a local nonprofit or charity.

To be considered for a free annual membership please complete the following application:

Persons interested in applying for more than one person per application, please email bcycle@dsmstreetcollective.org

Recipient Name *

Recipient Email *

Recipient Phone *

Sponsor Name *

Sponsor Email *

Sponsor Phone *

Sponsor Organization *

Organization Email *

Please briefly describe why the recipient should be awarded an annual bike share membership *

Please answer the following: *

Recipient consents to a photograph and/or video testimonial about the bike share scholarship

Required

Submit

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