* 1. What is your name? (first name, last name)

* 2. What grade are you in?

* 3. Where do you go to school?

* 4. Primary phone number?

* 5. Why are you interested in the Major Taylor Ride Club (two or three complete sentences)

6. Are there any other extracurricular activities you participate in?
Please include the time(s) you are committed to those activities.

7. Will you be able to attend all ten meetings?

8. Do you have access to transportation?

9. Do you know how to ride a bicycle?

10. Do you own (or have access to) a bicycle?