Bicycle Registration Form

Name Name * First Last
Email
MavID Number
Select One

Select One Faculty Staff Student Other
Local Phone Local Phone - ### - ### ####
Bicycle Information
Serial Number *
Manufacturer
Model

Model Men's Women's
Color *
Style
Expected graduation date
Please confirm *

Please confirm All of the above information is true and accurate to the best of my knowledge. I will immediately notify the Crime Prevention Unit in writing of any changes