Bike Works · Bicycle Donation Receipt

Donation Information

Description of Donated Item(s)

*

Approximate Value

*

Where did you drop off your donation?

*

Bike Works shop/warehouse

North Transfer Station

South Transfer Station

Rapha Seattle

ReRack Renton

Community bike drive/other (please specify)

Where did you drop off your donation?

If this was through a community bike drive, please tell us who hosted.

Contact Information

Name

*

First Name

Last Name

Email

*

Verify Email

*

Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Promote Bicycling

We request a $5 donation or more per bike to help get your bike fixed up and ready to roll back out into the community.

I would like to donate to help get my bike into positive use again.

*

Yes, I want to promote bicycling

No thank you, not today

Amount

$50

$25

$10

$

Donation Schedule

Tell your bike's story here!

Demographic Info

Please help us evaluate our efforts to foster an equitable and inclusive environment by sharing some information about yourself. This information is confidential, optional, and anonymous. We are surveying our community so that we may assess our work through an equity lens.

Race/Ethnicity

American Indian/Alaska Native

Asian

Black/African American

Latine

Pacific Islander

Mixed Race

White/Caucasian

Other (please specify)

Race/Ethnicity

Gender

Female

Male

Non-binary

Transgender

Other (please specify)

Gender

Pronouns

He/him

She/her

They/them

Other (please specify)

Pronouns

Socioeconomic Experience

More information about class distinctions here: https://resourcegeneration.org/breakdown-of-class-characteristics-income-brackets

Underemployed/underpaid; basic living expenses might be impossible/difficult to obtain; unstable housing (20% of the U.S. population)

Employed with limited access to savings, benefits, or flexibility in hours or pay; generally living paycheck to paycheck; rental housing (40% of the U.S. population)

Depends on salary to pay bills, may have mortgage or education debt; access to college education; home ownership or rental (20% of the U.S. population)

Savings/investments may allow for early retirement; may receive or give inheritance; little to no debt; access to college education; managerial or professional employment; owning one or multiple homes (19% of the U.S. population)

Assets make full-time work optional; may receive or give large inheritance; no debt; access to prestigious education; managerial or professional employment; owning one or multiple homes or luxury homes (1% of the U.S. population)

Birthdate

Sharing your birthdate helps us track when youth age out of youth programs as well as assess our effectiveness at building a multigenerational community.

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