* 1. Your name

* 2. Phone

* 3. Email address

* 4. Town

* 5. Are you interested in doing an electric conversion of your bike at the workshop?

* 6. What is the wheel size of your bike? (look on the side of the tyre)

* 7. Do you want a front hub or rear hub motor?

* 8. The kits will cost between $580 and $620 depending on the final discount we can negotiate. We have secured a small grant which will enable us to subsidise up to a ten people to buy kits. This will mean the kit will cost you between $420 and $500. Can you commit to this payment?

* 9. This workshop is part of a series of workshops, made possible with a grant through the Tasmanian Climate Change Office. Please indicate if you would be interested in attending or hearing about any of the following workshops or forums.

* 10. Please feel free to add any further comments or questions.

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