Town of Menasha Police Department,

  Menasha Police Department,

Neenah Police Department

Bicycle Registration Form

Your full name:

Address:

City/Town: State: Post./Zip Code:

Sex: M F

Race:  Indian  Asian Black  White  Unknown 

Phone number (with area code):

Date of birth:

E-mail address: (Optional)

BICYCLE INFORMATION

MAKE:

MODEL:

COLOR:

SERIAL #:

WHEEL SIZE: (10"-27"):

FRAME: BOYS     GIRLS    LADIES    MENS    BMX    MNT. BIKE  

YOUR BICYCLE REGISTRATION STICKER WILL BE SENT TO YOUR HOME ADDRESS WITHIN 5 BUSINESS DAYS.

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