Existing Distribution Partners may use this form to request bikes. Name of Organization Select Alpha Grand Rapids Arbor Circle AYA Youth Collective Bethany Christian Services CarePortal Catherine's Health Care Crossroads Bible Church Degage The Delta Project Dwelling Place Eagle Village Exodus Place Family Outreach Center Family Promise Friends of Grand Rapids Parks Guiding Light Health Net of West Michigan HELP Pregnancy Hero's Corner Mel Trotter Ministries Michigan Department of Corrections Our Hope Pediatric Oncology Resource Team Pine Rest Puertas Abiertas Refugee Education Center The Right Door Safe Haven Ministries Samaritas Spectrum Automotive Solutions The Source Steepletown Neighborhood Services Sunshine Community Church Urban Family Ministries Women's Resource Center Treetops Collective Ukrainian Society of Michigan YWCA Requester Name * First Name Last Name Requester Phone * (###) ### #### Requester Email * Why bikes are needed? * Please be as specific as possible Number small bikes needed Height less than 5'6" Number medium bikes needed Height 5'6" to 5'10" Number large bikes needed Height 5'10" to 6'1" Number x-large bikes needed Height greater than 6'1" Thank you. We will contact you about fulfilling your request shortly.
