2016 Safe Routes to School Bicycle Fleet Solicitation Application
Please fill out this form to apply for a bicycle fleet and trailer. Application deadline is
5pm, June 1, 2016. See the Safe Routes to School Bicycle Fleet Application Guide for
more details.
School/Organization Information
Applicant name:
School names:
City:
County:
Contact Information
Primary contact name:
Telephone number:
Email address:
Mailing address:
SRTS Program Information
Does this school have a Safe Routes to School plan (if yes, please provide a link to the
plan)?
Briefly describe existing SRTS activities (SHIP school support, Walk! Bike! Fun! Curriculum
taught, SRTS planning, annual evaluation with student hand tallies etc.) at this school (Limit 250
words):
Please list the names of people and organizations that champion SRTS in the communities that
will be served.
School Questions
How many students will benefit from the use of the bicycle fleet?
Please list the schools that will use the bicycle fleet, include:
•
•
•
the grades and number of students who will use the fleet at each school or
organization
the number of students within two miles of each school
the number of students who qualify for free and reduced lunch
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Please list the other organizations who will use the bicycle fleet and the number of
youth they expect will use the bicycle fleet.
School or Organization
Grade
level/Age
# Students
or youth
reached
# Students
2 miles from
school*
# Students
free/reduced
lunch*
TOTAL
*Schools only
Program Questions
Tell us about the schools and youth programs your organization serves and your plan to
integrate the bike fleet.
Bike Fleet Questions
Do you have a secure area to store the bikes and trailer? Yes __ no___
Please describe the location:
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Do you have access to a vehicle and staff capable of hauling the trailer? Yes __ no __
Please describe:
Do you have staff resources to schedule, move and perform basic maintenance?
Yes __ no__
Please describe:
Briefly describe your plan to maintain the bicycle fleet for at least 5 years. Estimated annual
parts and service are anticipated to range from $2,000-4,000. (Limit 250 words)
Would you require bicycles, trailers and equipment or are you applying for a partial grant
award? If you are applying for only one component of a fleet (bicycles or trailer but not both)
please indicate so here and describe your reasoning.
Are there any additional funding sources you will leverage or match MnDOT funds for this fleet
of bicycles? If yes, please explain.
Evaluation Questions
Successful applicants will be required to collect surveys about student travel behavior and hand
tallies on how students travel to school.
Is your school willing to assist in collecting this data?
___ Yes
___ No
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Is your school currently collecting this data or evaluating additional SRTS activities? (working
with SHIP, previous MnDOT grants, other )
___ Yes
___ No
Able to meet grant requirements?
___ Yes
___ No
School Administrator Resolution
Along with these questions, submit a resolution of support to enter into a contract
from the school board or other governing body to meet the state program
requirements. An example will be posted on the SRTS website with this application
packet.
Application submission
The complete application and school form should be e-mailed to the Safe Routes to
School e-mail address provided below by end of business day on June 1, 2016.
Applications can also be mailed to MnDOT.
Postal Mail:
Dave Cowan
Office of Transit
Transportation Building
395 John Ireland Blvd.
Mail Stop 315
St. Paul, MN 55155
E-mail: [email protected]
Or Click Here to Submit Immediately via PDF:
Submit Now
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