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Please print and fill out the following information.

Send the application to:

LACBC
634 S. Spring, Suite 820
Los Angeles, CA 90014
Make check payable to Los Angeles County Bicycle Coalition

YES, I WANT TO BECOME AN LACBC MEMBER!
Name:_______________________________________________________
Address:____________________________________________________
City:__________________________ State:____ Zip:_____________
Phone:________________ E-Mail:______________________________
___$25
___$52
___$100
___$10

___$35 

___$150-$2500

Grand
Sunset
Broadway!
Olympic (student / low income)
 
Family (2 members/1 newsletter)
 
Become an LACBC Sponsor!
Call us for details. 213-629-2142.
$52 or more gets you an LACBC T-shirt!
Circle Size:   S   M   L   XL   XXL
Circle Style:   English    Bilingual

I'm interested in getting involved!
I want to volunteer by:
___Getting involved with an LACBC campaign (circle):   Long Range Planning,   L.A. River,
       Call for Projects-Increased Bike Funding,   Bike access on Transit,   Education.
 
___Attending public meetings/events   ___Newsletter production/mailing/distribution
 
___Staffing an informational table     ___Office assistance   ___Phone calling
 
___Valet bike parking at events   ___Board member   ___Other


I use my bike for the following (circle):   work/commuting   recreation   errands   other_______

My idea to make L.A. more bicycle friendly or additional comments: