Freewheels bike request form

Freewheels receives more requests for bikes than our capacity to build and repair them. When you complete and submit this form, your name will be added to our waiting list. 

We give priority to people who have been referred by refugee resettlement agencies as well as agencies helping veterans emerging from homelessness. We advise you to coordinate your request with your case manager.

Please submit a separate form for each person requesting a bike. We do not distribute bikes to children younger than 11 years old.

If you are not a refugee or a veteran, you may submit this form but we cannot provide an estimate of when you will receive a bike.

Please include your case manager’s name and their contact information. Providing your height helps us make sure that we have a bike in our inventory that will give you a comfortable ride.

We will notify you when we have a suitable bike.

PLEASE DO NOT COME TO OUR SHOP UNTIL YOU RECEIVE AN EMAIL NOTIFICATION THAT A BIKE IS READY FOR PICKUP. If you don’t have this email notification, we will not give you a bike.

Page revised 09/05/2024.