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Friday, February 22, 2019
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Bicycle Registration Form
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Please complete the online form below to register a bicycle with the Clayton Police Department. If you have any questions or concerns, please contact the Clayton Police Department at (302) 653-8186.
Personal Information
First Name:
*
Middle Initial:
Last Name:
*
Street Address:
*
Apartment Number:
Subdivision:
City:
*
State:
*
Select a State
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Zip Code:
*
Home Phone:
Alternate Phone:
Email Address:
*
Birth Date:
*
School or Employer:
*
Parent or Legal Guardian:
(put N/A if over 18)
*
Phone Number:
(put N/A if over 18)
*
Bicycle Information
Make & Model:
*
New or Used:
*
New
Used
Serial Number:
*
Frame:
*
Boys
Girls
Brakes:
*
Hand - Front or Rear
Coaster
Wheels:
*
16
20
24
26
27
28
Color of Frame:
*
Color of Fender:
*
Accessories and Notes
Accessories:
Additional Notes:
Person Submitting Form:
*
Date Submitted:
*
* indicates required fields.
Town of Clayton
P.O. Box 1130
414 Main Street
Clayton, DE 19938
Ph: (302) 653-8419
Fx: (302) 653-2017
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