Bicycle License Application

2. Thank you for your registering your bicycle with the Northbrook Police Department. Bicycle registration is free. Having your bike registered increases the chance of it being returned if it is lost or stolen.
   
   After completing this online registration form, you will receive a license sticker in the mail. This sticker should be applied to the bar located underneath the bicycle seat, facing forward. If you have any questions, please feel free to contact the Northbrook Police Department Records Section at 847-564-2060.
4. Owner
   (Must be an adult age 18 or over)
6. First Name*
7. Last Name*
8. Middle Initial
10. Address*
12. City
13. State
14. Zip Code
16. Phone Number*
17. Email Address*
19. Boys or Girls*
    -- Select One --BoysGirls
23. Bicycle Information
    (Please fill in as much as possible)
25. Make
26. Model
27. Frame Color
28. Trim Color
30. Serial Number
31. Wheel Size
    (Inches)
32. Speed Gears
33. Value
35. Owner Applied Number
36. Comments
    (Any other information or special features that may help us locate or identify your bicycle)
Leave This Blank:


38. 1. Receive an email copy of this form.
39. Email address

    This field is not part of the form submission.

40. Submit

* indicates a required field