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1. Your Name:

2. Phone or Email:

3. The complete Cycling Savvy curriculum consists of 3 sessions: (1) the "Train Your Bike" skills session, (2) the "Truths & Techniques of Traffic Cycling" classroom discussion, and (3) the on-road "Tour of Portland". The first two may be taken alone, and in either order, but are both required for the third. Do you think at this time you are interested in

4. If you are interested in all 3, would you rather do the sessions

5. Which weekend times will usually work for you in the summer? (check all that apply)

6. Which weekday evenings are usually good for you in the summer? (check all that apply)

7. Do you know what dates this summer you'll be NOT available (vacations, holidays, out of town, etc.)?

8. In what town do you ride the most?

9. Are there any streets or intersections that you find especially challenging?

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