Skip to content
Miles of Freedom
6-Month Adventure Cycling Program Application
Please answer the following questions as honestly and in as much detail as possible.
OK
*
1.
Please answer the following questions.
(Required.)
First Name
Last Name
Email Address
2.
How did you hear about Miles of Freedom?
3.
What is your branch and dates of service?
4.
Tell us a little bit about yourself
5.
What do you feel is your greatest challenge at this time?
6.
What is your desired outcome from participating in this program?
7.
What would that outcome be worth to you?
8.
Do you have any medical conditions that may impact your ability to participate in rigorous exercise?
9.
If selected, do you agree to meet all of the program requirements such as attending weekly planning meetings, participating in all cycling trips, and maintaining sobriety?
I agree
10.
Is there anything you'd like us to know?
Thank you. A representative from our organization will be in touch with you soon!
Current Progress,
0 of 10 answered
