CityWheels Carshare Club
P.O. Box 606146
Cleveland, Ohio  44106

Tel: 216.795.2345
Fax: 216.452.9333

NOTE: Fields marked * are required

First Name: *
Last Name: *
Email Address: *
Company Name (if applicable):
Primary neighborhood or district where you would reserve a CityWheels car:
How frequently might you drive?		(Select One) 2 or more times per week 4-6 times per month 1-3 times per month Less than once per month
Could you avoid the need to own a car (or get rid of a car you now own) if CityWheels works for you?		(Select One) Yes, I'm likely to buy a car if CityWheels doesn't work for me Yes, I hope to get rid of at least one car No, I have no plans to buy a car - whether I join CityWheels or not No, I'll still keep (all of) the car(s) I now have I'm not sure
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