BSR Order Form

ORDER FORM

*Required fields.

1. Contact Information

First Name*:	Last Name*:
Company Name:
Email Address*:

Billing Address
Street*:

City*:	State*:	Zip Code*:
Telephone*:	Fax:
Have you order from us before?	Yes	No

2. Shipping and Payment

Ship To Address (if different from above)
Street:

City:

State:

Zip Code:

Your Purchase Order#:

Shipping Method*:
           Ground
           3-day
           2-day
           Next day
           Other (please state other method in the comments section below)

Payment Method*:
           COD (for dealers only)
           Credit Card (please contact us by phone with your CC#, this is
                not a secure site)
           Prepaid Money Order (we must receive before we ship)


3. Technical Information for Rim and/or Spoke Orders

Motorcycle:
Year:	Make:	Model:


	Front Wheel	Rear Wheel
Rim Width:
Rim Diameter:
Rim Manufacturer:
Drum or Disc?
Conical or Full Width?
Hub Manufacturer (if aftermarket):
If Talon: Hub #:


4. Part numbers and Quantities

Quantity	Item No	Desciption

Comments:

WE APPRECIATE YOU LOCATING THE PART # FOR YOUR APPLICATION. HOWEVER, WE DO MANUFACTURE CUSTOM SPOKE KITS FOR AN ADDITIONAL COST OF 10%.
WE WILL NOT REFUND FREIGHT ON RETURNED PRE-PACKAGED SPOKE KITS THAT ARE ORDERED BY DESCRIPTION RATHER THAN PART #.
By clicking on the "Place Order" button you have agreed to our terms and conditions.