Tower Hamlets Wheelers - London Cycling Campaign

Cycle Training & Bike Buddy Scheme

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Welcome to the Tower Hamlets Wheelers Bike Buddy scheme!
Any adult who lives, works or studies in Tower Hamlets is welcome to join.

If you require further information please read the Frequently Asked Questions page.

To get started, please fill in the following introductory questionnaire. Once we have received your details we will send you our information pack and give you further details to get you started with the training you require.

We will not pass any of your personal information on to any other organisation, except possibly your name and contact details to the two cycle training companies working in partnership with our scheme to ease the booking process. We would like to use some of the general data in the 'write-up' of the project but it will always remain anonymous. Please advise us if this arrangement is not acceptable.

Introductory Questionnaire

Questions 1-11 are about yourself:
1.	First Name(s):
2.	Surname:
Questions 3-6 will help us ensure that we assist a range of different people in Tower Hamlets, reflecting the composition of Tower Hamlets residents as much as possible. We are aiming to include the whole community. Read the Wheelers' Equal Opportunities Statement.
3.	You must be aged 16 or over to be eligible for the scheme. Please state which range your age falls into:	16-19 20s 30s 40s 50s 60+
4.	Sex:	Female Male
5.	Please describe your ethnic origin:
6.	Employment status:	Working full-time Working part-time Retired Unemployed Doing unpaid full-time work Student
7.	Why do you want to cycle in Tower Hamlets?	Resident in borough To get to work, study or general visiting (non-Tower Hamlets resident) To travel through borough (non-Tower Hamlets resident)
8.	Indicate any regular journeys you do or would like to undertake by cycle e.g. commute from Bow to the City, travel from Hackney to college in Mile End.
9.	Full address (including postcode):
10.	Contact telephone number(s):	Mobile Daytime Evening
11.	Email Address:
Questions 12-19 are about you and your cycling:
12.	Can you ride a bike?	a) No, I have never learnt b) Yes, I learnt when I was a child but haven't ridden since then c) Yes, I learnt when I was a child and have given it a go again recently d) Yes, I have learnt recently
If you chose a) or b) go to Q17.
13.	Do you cycle at the moment?	a) No b) To commute c) For leisure d) To commute & for leisure
If you chose a) go to Q17.
14.	On average, approximately how often do you cycle?	Daily Several times a week Weekly Monthly
15.	Which type of routes do you mostly cycle on?	Quiet roads Off-road (canal tow-paths, bridleways etc.) Any road
16.	How would you describe your cycling confidence level on roads?	Not confident on any roads Confident only on quiet roads Confident on all roads
17.	Do you currently own a bike?	Yes No
If No go to Q19.
18.	Would you like your bike given a mechanical safety check?	Yes No
19.	What bike accessories, if any do you own?	Lock Lights Helmet Visibility/reflective strips Puncture repair kit Other (please specify)
20.	Why do you wish to join the Bike Buddy scheme? Tick all that apply.	To learn to ride a bike To get around more quickly To save money To get some exercise To be confident enough to cycle on roads I can ride on quiet streets but would like to try cycling on busy roads I am confident and competent but would like 'booster' lessons I would like general help e.g. finding good routes, advice on bike equipment Other (please specify)
21.	How did you first find out about the Bike Buddy scheme?

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