I Want to be a Perimeter Pedaler!

Thank you for your interest in cycling as a commute alternative.

By completing the following form, you will not only be helping yourself find
a better way to work, but you will also be helping PTC in their mission to
raise awareness, reduce congestion, and improve mobility in the Perimeter
area.

Are you interested in riding your bike to work but unsure of the best route to take?
Yes
No

Are you interested in having an experienced cyclist who is familiar with the area ride with you to and/or from work so that you can get a better feel for your route during rush hour?
Yes
No

Would you like the PTC to mail you a Bike Map of the Central Perimeter area?
Yes
No

If you answered yes to any of the above questions, please fill out the following form:

First Name

Last Name

Home Address
Street
City
State
Zip
Employer Name
Employer Address
Street
City
State
Zip
Work Phone
Email Address
Normal Commute Hours I normally leave my home for work at:
I normally leave my work for home at:  

How would you rate your level of cycling experience/expertise; from 1 to 5 with 1 = haven't ridden a bike since I was a kid and 5 = relatively comfortable riding in rush hour traffic?

What type of riding do you currently do?
Check all that apply.
Mountain Biking
Recreational Trail Riding
Road Riding alone
Road Riding with a group
Riding for Commuting Purposes
Don't Ride Currently

What kind of bike and equipment do you own?
Check all that apply.
Mountain Bike
Hybrid Bike
Road Bike
Recumbent Bike
Lights for night riding
Panniers (saddlebags)
Backpack/Commuter bag
Bike Lock
Helmet
Other:

What bicycle facilities are currently available at your worksite?
Check all that apply.
Covered bike parking rack
Non-covered bike parking rack
Free Shower facility
Pay Shower facility
Lockers for bicycling commuters
Don't know

Would you be interested in learning more information regarding the following?
Check all that apply.
Effective Cycling Courses
Atlanta Bicycle Campaign
PATH Foundation
Group Rides in the area

Additional Comments/Questions:

 
Perimeter Transportation Coalition
211 Perimeter Center Parkway, Ste. G-1
Atlanta, Georgia 30346
phone: 770-394-4540 fax: 770-394-4542
email: info@perimetergo.org