South Central Power Up

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A people powered e-bike lending library.

Please fill out this form if you are interested in participating in the neighborhood-based South LA e-Bike Lending Library. The contact information on this form will be used to reach out to you in the coming months as bikes become available to area residents. The information you submit will not be used for sales or marketing purposes, but may be shared with organizations partnered with the e-bike lending library.

Complete este formulario si está interesado en la Biblioteca de Préstamo de Bicicletas Eléctricas del Sur de Los Ángeles. La información de contacto de este formulario se utilizará para comunicarnos con usted en los próximos meses a medida que las bicicletas estén disponibles para los residentes del área. La información que envíe no se utilizará con fines de ventas o marketing, pero puede compartirse con organizaciones asociadas con la biblioteca de préstamo de bicicletas eléctricas.

Name / Nombre

Email / Correo Electrónico

Phone / Número de Teléfono

How would you like to stay informed? /
¿Cómo le gustaría estar informado? *

Text

Other:

18 or older? (Must be at least 18) / ¿Edad? (al menos 18 años)
*

18-24

25-30

31-39

40-49

50+

Zip code / Código Postal
*

How did you hear about the service? / ¿Cómo se enteró del servicio?
*

Community Services Unlimited + Village Market Place

Esperanza Community Housing Corporation + Mercado La Paloma

Los Angeles Cleantech Incubator

People for Mobility Justice

Ride On! Bike shop/co-op

RIDEWITUS LA Bike Store & Club

Strategic Concepts in Organizing and Policy Education (SCOPE)

Labor Community Strategy Center

TRUST South LA

Other:

Required

Select up to 2 organizations/locations that are easily accessible to you. / Seleccione hasta 2 organizations/locaciones que son acesible facilmente para ti. *

Community Services Unlimited - Village Market Place (6569 S Vermont Ave, Los Angeles, California, 90044)

Esperanza Community Housing Corporation - Mercado La Paloma (3655 S Grand Ave, Los Angeles, CA 90007)

RIDEWITUS LA Bike Store & Club (5339-B W. Centinela Avenue, Los Angeles, CA 90045)

Strategic Concepts in Organizing and Policy Education (SCOPE) (1715 W Florence Ave, Los Angeles, CA 90047)

Labor Community Strategy Center (3540 W Martin Luther King Jr Blvd, Los Angeles, California, 90008)

TRUST South LA (4331 S Main St, Los Angeles, California, 90037)

Ride On! Bike Shop (4319 Degnan Blvd Los Angeles, CA 90008)

Required

The following 2 questions will collect height and weight info. This will only be used to help fit you to a bike. We will not share this information with 3rd party organizations.

Las siguientes 2 preguntas recopilarán información sobre altura y peso. Esto sólo se utilizará para ayudarle a adaptarse a una bicicleta. No compartiremos esta información con organizaciones de terceros.

Height (Please enter your height in #ft #in) / Altura (Ingrese su altura en #ft #in) *

Weight (Please enter in lbs) / Peso (ingrese en libras) *

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