2. Please use this form to provide us with relevant information so we can get can work with our partners to get this repair station fixed as soon as possible. Please allow at least 2-3 weeks for most repairs. If you discover severe damage a the fix it station, such as a vehicular collision, or if the damage may cause a risk to health and safety, please call 706-613-3620. 

4. Date*
   Date
6. Bike Repair Station Location*
   -- Select One --ACC/Boulevard Woods Park- 298 Barber StACC/Dudley Park- 100 Dudley Park RdACC/East Campus Connector & Greenway Trail IntersectionACC/Greenway Parking Lot at MLK Pkwy and College AveACC/Sandy Creek Nature Center- 205 Old Commerce RdACC/Virginia Walker Upper Parking Lot- 200 Trail Creek StACC/Virginia Walker Trail Creek Trail- 167 Trail Creek StAlps Road Village Kroger- 191 Alps RdAthens Orthopedic- 125 King AveCollege Ave Parking Deck- 289 College AveUGA/Applied Genetics Technologies- 111 Riverbend RdUGA/Miller Learning Center- 48 Baxter StUGA/Myers Quad- 310 Sanford DrUGA/Plant Sciences- 120 Carlton StUGA/Ramsey Center- 55 Carlton StUGA/Main Library- 320 S. Jackson St

   Please select the location of the repair station from the drop down menu. 

8. Please let us know what needs to be repaired. *

   Select the boxes that describe the issues you are seeing or experiencing with the bike repair station. 

   1. Air pump not pumping air
   2. Air pump valve head missing or broken
   3. Graffiti on repair station or cement pad
   4. Missing Tool(s)
   5. Repair station has sustained major damage (such as a vehicle collision)
   6. Tool cables are partially cut or sharp
   7. Other (please explain in the Additional Information box below)
10. Additional Information

    Feel free to add any additional information you think is relevant. Thank you!

12. Photo or video of the damage or issue.

    If you are able to upload an image or video of the problem, that would be very helpful. If tools are missing, please take a photo of all the tools that are still present (see example). 

14. Additional photo if needed.

    If you are able to upload an image or video of the problem, that would be very helpful. If tools are missing, please take a photo of all the tools that are still present (see example). 

16. Photo example of missing tool request.
    

    By taking an image of the tools still present, we can determine exactly what is missing. 

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18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit

* indicates a required field