Please fill out the following page, print it and ship with your components to ShockworX Motorsports

Name:__________________________________________________________

Address:________________________________________________________

City:__________________________State: ______ Zip:_________________

Phone:__________________________

Email: __________________________

Credit card #:_____________________________________________

Exp. Date_________________ Security Code________________

Model:_____________________ Year__________ MX___ XC___ TT___

Rider Weight with gear: _______ If Racing, what class: ________

A-arm Length & Brand: __________________________

Swingarm Length & Brand ______________________ Linkage: _______

Parts Shipped: _______________________________________________

Please list services that you would like us to perform & any additional notes.

_______________________________________________________________

_______________________________________________________________

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SHockworX Motorsports

1122 Oklahoma Ave

Trenton, MO 64683

Text Message Us @ (660) 654-3040

(660) 654-3040 shop

(660) 339-7018 fax