Bike Commuter Spirit Award Nomination

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* 1. Nominee name

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* 2. Nominee employer

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* 3. Employer address

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 4. Commute starting location

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* 5. How long has this person been commuting by bike?

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* 6. Does this person commute by bike year round?

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* 7. Does this person's employer provide bike incentives? (Check all that apply)

Bike racks

Clothing lockers

Showers

Subsidy

Other (please specify)

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* 8. Why did you nominate this person?

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* 9. Tips or recommendations for other people interested in biking to work?

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* 10. Do you know of any health benefits this person noticed?

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* 11. Your name

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* 12. Your email

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* 13. Your phone number