If your business is interested in participating in the SHOP DINE BIKE program please fill out the form below.

Business Information

Business name:
Website:
Facebook:
Twitter:
Upload logo (JPG, PNG, or GIF format preferred):

Location(s)

Address:
City:

CA
Zip:
Location Hours:
Address:
City:

CA
Zip:
Location Hours:
Address:
City:

CA
Zip:
Location Hours:
Address:
City:

CA
Zip:
Location Hours:
Address:
City:

CA
Zip:
Location Hours:

Contact Information

(for Bike Month staff - not displayed to public)
First name:
Last name:
Title:
Contact Email:
Contact Phone:
Best way to contact you:  
Best time of day to reach you:  
Are you interested in meeting with a MIBM representative (or SABA) to learn how to become a bicycle friendly business/employer?