Bike Donation Form

Name

Email Address

Address (House number/name, street, town, postcode)

Telephone (Mobile preferred)

Make of Bike

Model of Bike

Age of bike (if known)

Is the frame free from dents Is the frame free from dents Yes No

Is there excessive rust to the chain / cogs / frame? Is there excessive rust to the chain / cogs / frame? Yes No

Has the bike been stored outside for a long period of time? Has the bike been stored outside for a long period of time? Yes No

More information on bikes to be collected