Your name

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* 1. Your name

Phone

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* 2. Phone

Email address

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* 3. Email address

Town

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* 4. Town

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

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

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

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

Do you want a front hub or rear hub motor?

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

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?

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* 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?

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.

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* 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.

Please feel free to add any further comments or questions.

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

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