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Thank you for your interest in the Sustainable, Affordable, Firesafe, E-Bike (SAFE) trade-in program facilitated by the Equitable Commute Project. We are offering discounted UL-2271 certified batteries in exchange for non-certified batteries.

ELIGIBILITY: This program is open to full-time or part-time delivery workers who can demonstrate $500 in delivery income over past 6 months. You must trade in your non-certified battery to access the special pricing.

TO APPLY: Please fill out this form and upload the required documents. We will process your application and let you know if you are approved within three business days.

QUESTIONS: E-mail info@equitablecommute.org

DISCLAIMER: By submitting this form, you agree that the Equitable Commute Project may use the information you provide, including but not limited to your name, email, and/or phone number, to verify your status as a delivery worker with the applicable delivery platform. Note that filling out this form does not guarantee participation in the trade-in program.

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* 1. What is your name?

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* 2. What is your email address? Please be sure to use the same email address throughout this process.

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* 3. What is your cell phone number? Please be sure to use the same phone number throughout this process.

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* 4. How long have you made deliveries?

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* 5. Which of the following apps do you deliver for? (select all that apply)

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* 6. In which borough do you live?

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* 7. How often do you make deliveries?

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* 8. In which country were you born?

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* 9. What micromobility vehicle do you currently ride? (Note that these batteries will only work on the below-listed vehicles)

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* 10. Where did you buy your e-bike?

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* 11. How long have you had this e-bike?

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* 12. Where do you currently charge your vehicle?

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* 13. Why are you interested in this program?

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* 14. How did you hear about this program?

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* 15. This program offers the PW Arrow-10 Compatible battery for $152.50 (plus tax). To access this pricing, you must forfeit your current battery(s) and charging cords. Please confirm how many batteries you would like to exchange.

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* 16. Please upload a photo of the battery(s) you plan to trade in. You must trade in your old battery(s) to access the special pricing listed above

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* 17. Please upload one document that shows your name and proof of income from delivery work. This can include:

-A pay stub

-A bank statement (that shows the name of the delivery app)

-A 1099 tax form

-A letter from your employer (e.g., a restaurant that you deliver for)

(Note that you must have at least $500 in income from delivery work in the past six months). For questions, please email info@equitablecommute.org.

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