Submission Form

EmailMeFormCycle Video Day Submission Form

The only required information is your video link. All other information is voluntary, but might make for some interesting statistics.

• 
  URL of Cycle Day Video *
  
• 
  Describe Your Video in 25 Words or Less
  
  <br />
• 
  Rate Your Cycle Commuting Today Out of 10
  
• 
  How Many Other Road Users Did You Thank Today? (Estimate)
  
• 
  How Many Other Road Users Did You Think Acted Poorly Today? (Estimate)
  
• 
  Location (Rough Location is Fine)
  
• 
  Anything Else You Wish to Share About Your Commute or Cycle Video Day?
  
  <br />
• 
  
  
• 
  
  

Powered byEMF Form Builder

Report Abuse