Register your bike on-line.
It's fast! Convenient! Super Easy!
Receive a small, aluminum Security ID tag.
Once placed on your bike it's almost impossible to remove!
West Palm Beach Police Department
Internet Report Form
Please fill in the form below completly. Then Click the "Submit" button at the bottom of this page. Required fields are deonoted with an asterik "*". If a required field does not pertain to you, please type "n/a" in that area.
Bicycle Registration Form
Street Address:
Apt or Unit No:
City:
State:
Zip Code:
Home Telephone:
Date of Birth:
Bicycle Make:
New:
Used:
Bicycle Model:
Serial Number:
Frame Color :
Fenders Color :
Trim Color :
Frame Size:
Frame Style:
Girls'
Boys'
How many speeds?
Please select the items installed on your bike.
Front Fender
Rear Fender
Front Light
Rear Light
Front Basket
Rear Basket
Email Address:
Other remarks, comments, or questions:
**Suggested Donation: $2.00
Your donation will help fund
this program.
Please send $2.00 cash or check to:
Crime Prevention of West Palm Beach, Inc.
Post Office Box 851
West Palm Beach, Fl. 33402
Thanks!
Please note: Information collected through this form is intended for use by the West Palm Beach Police Department and not for distribution to third parties.
