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Bike to Work Day Home 
Registration Form 



Register today to take part in Bike to Work Day, May 20th, 2004! Complete the online form below, or download and print the PDF version.

This is the first time I've commuted by bike.
Usual mode of transportation to work:
Name:
Home Address:
Apartment #:
City:
Zipcode:
Company Name:
Company Address:
Home Phone:
Work Phone:
Email:

I would like to receive notices about services for bicyclists and other regional transportation services.
I am willing to be included in market research related to bicyclists.

Please only one entry per person. To be eligible, form must be received by 5/28/04. All winners will be selected by random drawing. Winners give permission for their names, cities of residence and photographs to be released. Winners are responsible for any federal, state and local taxes. Some restrictions may apply. Employees of MTC and partner agencies and their family members are not eligible to win prizes.

BIKE BUDDY MATCHING
»
Bike Buddy - New to biking? Find an expert to show you the way. Experienced rider? Find out how you can help new riders get started.
LOCAL RESOURCES
» Bicycle Organizations -Information and resources for bicycle enthusiasts.
SPONSORS
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Brought to you by MTC and Bay Area Transportation Partners



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