Bicycle Locker Application

This form is to allow for Bicycle Locker Privileges for consumers at RCTC's Metrolink Stations. Please register or re-register for a Bicycle Locker by filling in the information on this form. Incomplete applications will not be processed.

Boarding Station:

Name:
Home Address:
City:
Zip:
Nearest Cross Street to your Residence:
Daytime Phone:
Train Times:	AM PM
Email Address:
Employed by:
Employement Address:
Employment City:
Employment Phone:
Bicycle Make:
Bicycle Serial #:
Driver's License # (or State ID Number):
Locker # (if you have one):
Key # (if you have one):
Have you discontinued your use of the Bicycle Locker? (Do not reply if you do not have a Bicycle Locker):	Yes No
How often do you use the Bicycle Locker?
I agree to the new terms and conditions. (You must agree in order to use the Bicycle Locker)	Yes No


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