Dealer________________________________________ Rider_____________________________________________

Return Shipping Address:____________________________________________________________________________________

Daytime Phone:_________________________________ Evening Phone:_______________________________________

Make: ________________________________ Model:_____________________________ Year:__________________

Rider Weight (in gear):__________________ Classes Raced:_______________________________________________________

Outdoor Motocross __ Supercross __ Woods/Enduro __ Desert __ Hare Scrambles __

Freestyle __ Short Track __ Half-Mile __ Mile __ Snocross __

Terrain (Please check one or more)

Hard Pack __ Intermediate__ Sand __ Rocks(Tight Woods) __

Work to be Performed:

Revalve Shock __ Revalve Forks__ Service Shock __ Service Forks __ Replace Fork Seals __

Modify Head __ Port Cylinder (remember to send power-valves) __ Match Cases __ True/Rebuild Crank __

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COD __ Money Order Enclosed __ Visa __ Mastercard __

Card Number:_______________________________________________________ Expiration Date:________________________

Card Holders Name:________________________________________________________________________________________

UPS Ground __ UPS 2^nd Day Air__ UPS Next Day Air __ Other

Note: Return shipping is not included. Please call for total amount.

Please fill this form out and attach it to an e-mail or print it and send with your components.

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