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RACE REPAIR / SERVICE ORDER FORM
Max Power Inc.
3001 Progress Rd.
Madison, Wi. 53716
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print this form, complete and include with your
cylinders. |
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| NAME: |
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| PH.# |
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| E-MAIL: |
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| DATE SENT: |
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| DATE NEEDED: |
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| BIKE
INFORMATION: |
| MAKE: |
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| MODEL: |
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| YEAR: |
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Please supply me with the services and or parts
specified below: |
Max Power/RPM's Mechanic/Pit Shirts
(Sizes M / L / XL / XXL / XXXL - $45) |
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Nu-Fit Flex Fitted Max Power/RPM's caps
(Sizes - small / medium OR large / XL - $25) |
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| Cylinder
Plate & Hone to Stock size |
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Weld
Repair (additional $65.00) |
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| Cylinder
Boring for Steel Sleeves |
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Hone
Repair only (additional $45.00) |
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| Wiseco
pro-Lite Piston Kit |
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Cometic
Gaskets |
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| Top End Bearing |
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CYLINDER EXPRESS |
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| Xtreme
Piston: Size & Part No |
............................................................. |
Quantity |
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| 2
Stoke Cylinder porting:
(additional $125.00) |
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| LOW
to MID Porting |
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| MID
to TOP Porting |
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| All
over performance Porting |
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Additional
Services
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OTHER
INFORMATION: (please provide as much information
about your jetting,
gearing, and aftermarket add ons - such as pipes,
silencers, reed cages etc.)
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PAYMENT METHOD:
We can return your Cylinder & or Parts UPS
COD Money Order / Cashier check only. Or we accept
Visa, Mastercard, Discover or American Express Cards. You can
also pay with a personal check, but all checks
will need to clear your bank before any merchandise
will be shipped.
I
would like to pay with: (please check one)
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| PERSONAL
MONEY ORDER |
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| VISA |
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(Please
enter your card
details and sign below) |
| MASTERCARD |
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| DISCOVER |
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| AMERICAN
EXPRESS |
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| Cardholder's
Name: |
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| Card
Number: |
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3 digit CVV code
(4 digit American Express) |
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| Expiration
Date: |
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I authorize Max Power Inc. to charge for
services received:
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| Cardholders Signature: |
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| Please remove below
label and adhere to box when shipping (cover with
clear tape) |
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SHIP
TO:
Max Power Inc.
3001 Progress Rd.
Madison, Wi. 53716
Attn: Incoming Goods |
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