2019 Partner Application Please fill out the application below for consideration in the 2019 benefiting partners selection process. Application deadline is October 19, 2019. Organization InformationOrganization Name*Mission Statement*Organization Tax ID #*WebsiteName of Main Contact for Organization* First Name Last Name Title/Role of Contact*Phone*Email* Address* Street Address City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code County*Phone*What geographical area does your organization generally serve?*MinneapolisSt. PaulNorth MetroSouth MetroEast MetroWest MetroWho does your organization serve? Check all that apply. Asian/Pacific Islander Black/African American Hispanic/Latino Native American/American Indian White/Caucasian Multiethnic Other Are you applying on behalf of a school or district?*No.Yes, Minneapolis Public Schools.Yes, St. Paul Public Schools.Yes, but my school district isn't listed.Has your organization been a partner with Free Bikes 4 Kidz in past years? If so, which years?*Please select all that apply. (Note: Answers to this question do not affect eligibility.) 2018 2017 2016 2015 2014 My organization has not partnered with FB4K in the past. Bikes RequestedPlease estimate the number of bikes your organization might need: (Note that the amount of bicycles Free Bikes for Kidz can provide is dependent on our inventory and competing demands of our partner nonprofits - this number is not guaranteed.)*What is the age group (or groups) for the bikes you are requesting?* 0-3 years old 4-6 years old 7-11 years old 12-18 years old ParticipationWould you or your organization be interested in coordinating volunteers from your staff or your youth/families to come volunteer at the Free Bikes 4 Kidz warehouse?*Yes!No, Thank you.Additional Education and/or EncouragementWe know that bikes are much more likely to continue to be ridden when our partner organizations have supporting education and encouragement activities. While we will try to meet the needs of all of our partners, we prioritize those that are able to do to any of the following. Please indicate what activities your organization plans to do with bike recipients:*Please select at least one option. Teaching helmet safety and fitting. Holding a bicycle rodeo, to encourage youth to ride and teach important safety skills. Teaching bicycle safety in the classroom or as a part of an afterschool activity. Organizing a bike club, to go on regular rides together. Organizing a bike train, to get kids in the neighborhood riding to school together. Teaching flat changing or other basic mechanics courses so youth can continue riding after a mechanical issue. We plan to use the bicycles as a part of a fleet of bikes for our school or organization's bike safety program. Put them in contact with community resources related to bicycling such as community bike shops, advocacy groups, etc. We don't have any activities planned, but would be interested in exploring more. PhoneThis field is for validation purposes and should be left unchanged.