|
Please print this form, enter your information, and fax it to
717.633.6649. A Bike-Rite USA Representative will call you to confirm your order. |
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| Name | ____________________________________ |
| Street Address | __________________________________________ |
| __________________________________________ | |
| Phone # | _________________________ |
| Quantity | _______ |
| Payment Method | ___ Visa ___ Mastercard ___ Check |
| (Please check one) | |
| ___ COD ___ Money Order | |
| Bike-Rite USA PO Box 144 McSherrystown, PA 17344 |