Form Center

2. Note
   Registering your bicycle with the Portage Department of Public Safety can assist officers with the return of a lost or stolen bicycle and the with criminal prosecution of a bike larceny. Bicycle registration is free, does not expire and may be updated at any time. The bicycle serial number, typically located on the frame of the bicycle, must be provided with the registration form. You may contact the City of Portage Department of Public Safety 269-329-4567 if further information about this program is needed.
4. Name
   Include first and last name and middle initial.
5. Email Address
7. Address
9. City
10. State
11. Zip Code
13. Main Phone Number / Cell Number
14. Date of Birth
16. Work Phone Number
20. Bicycle Information
22. Serial Number
24. Make and Model
26. Style (select one)

    1. Mountain / Trail
    2. Road
    3. BMX
    4. Other
27. If you selected "Other," please describe.
29. Gender

    1. Male
    2. Female
    3. Unisex
30. Color
31. Number of Speeds
33. Wheel Size
Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit

* indicates a required field