Contact Information
Last Name	First Name
Shop Name	Legal Owner Name
	(Corporation Name, LLC, etc.)
Shop Address
Street 1	Street 2
City	State   Select OneAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
Zip Code
Telephone	Fax
Email	Website
Mailing Address (if different)
Street 1 / PO Box	Street 2
City	State  Select OneAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
Zip Code
Shop Information
Bike Brands Carried	Do you carry triathlon accessories (wetsuits, goggles, triathlon apparel, aero helmets, aero wheels, etc.)? Full LineSomeNone
Years in Business
Hours of Operation:
Monday      Tuesday       Wednesday      Thursday
Friday      Saturday       Sunday
Can you provide temporary storage (24-48 hours) of approximately 20 fully-assembled bikes?
YesNo
If “No”, what is the maximum number of bikes you could accept?
Where is your storage area?  OnsiteOffsite Warehouse
Insurance
What is your shop's current Personal Property Limit of Insurance:
Do you have any endorsements to your policy (e.g., peak season)?  YesNo
If Yes, please note amount and period endorsement is in effect.
Additional Information
Do you work with, sponsor or affiliate with any teams, clubs or Pro/Elite athletes?
YesNo    If yes, with whom?
As a member of our affiliate network, list your top concerns or business goals.
If you are not interested in joining our Network at this time, please share ideas or suggestions that would make this opportunity more attractive to you as a store owner.
Final Comments: Please share anything you'd like us to know. Your feedback is very valuable to us!
Legal Disclaimer. All information provided on this application is confidential. Bike Sherpa LLC does not share, sell, rent, lease or otherwise publish and distribute any information provided to us without expressed written consent from each applicant. Upon joining our network, Bike Sherpa LLC will request your permission to include your shop name with contact information in our on-line directory. At no time will Bike Sherpa LLC share your information with any other third parties without your permission, unless required by law enforcement action, subpoena or local law.