Workplace BUG (Bicycle User Group) Registration Form

1. This will take 2 minutes

 
Add your Bicycle User Group (BUG) to the growing list of workplace BUGs by completing the following brief registration form.

By making yourself known to Bicycle Victoria we can stay in contact with you and make resources available to you.

If you permit us to do so, we will publish your email address on our growing online list of BUGs so that other BUGs and workplace members can make contact with you.

Registration form length: 10 questions
Time to complete: 2 minutes

Protecting your privacy
We collect, use, disclose and otherwise handle your personal information in accordance with the terms of our Privacy Policy Statement. See www.bv.com.au (Search: privacy) for full details. All information remains the property of Bicycle Victoria.

We do not collect personally identifiable information about you except when you specifically provide this information on a voluntary basis. We will make every effort to ensure that whatever information you provide will be maintained in a secure environment.
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1. What is the name of your BUG?
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2. What is the name of your workplace?
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3. What is your workplace street address?
4. What is your workplace postal address (if different from above)?
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5. What is your name?
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6. What is your phone number? (BH)
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7. What is your email address?
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8. How many people work in your workplace? (an estimate)
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9. How many people do you estimate will join your BUG in the next twelve months?
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10. Has your BUG planned any activities since forming (e.g. breakfast, meeting, workshop)?

If so, please list.
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11. Would you like Bicycle Victoria to add your BUG's contact details to our growing list of Australian Workplace BUGs on our webpage?

This is so that members of your workplace and other BUGs can contact you to join you or ask for some advice.
Protecting your privacy
We collect, use, disclose and otherwise handle your personal information in accordance with the terms of our Privacy Policy Statement. See www.bv.com.au (Search: privacy) for full details. All information remains the property of Bicycle Victoria.

We do not collect personally identifiable information about you except when you specifically provide this information on a voluntary basis. We will make every effort to ensure that whatever information you provide will be maintained in a secure environment.

If you have any questions about your involvement in this registration form, please feel free to contact Bicycle Victoria:
Ph 03 8636 8888
Fax 03 8636 8800
Level 10, 446 Collins Street, Melbourne Vic 3000
near corner of William Street
Melway Ref 1A F7
PO Box 426, Collins St West, Vic 8007
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