Order Form

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Order Form

All CYCLEBOOST kits
are hand made in

from materials from

and designed by a
guy of

descent!

Please complete this form in it's entirety. The more information we have. The easier it is to fulfill your order. Any information collected is used solely for the purposes of filling the order. No information is sold or exchanged with any other entity or organization.

Contact and Shipping/Billing Information:

Full Name:
Street Address:
City/Town:
Province/State:
Postal/Zip Code:
Country:
Daytime Phone #:
Fax #:
Email:

Taxes are calculated based on the destination of the parcel. All orders within Canada are subject to GST and all orders within Ontario are subject to GST & PST.

Product Quantities:

Description	Part #	A	B	C	Price Each	Qty
BOTTLEHOLDER Kit	BH-1	*			$28.00
SOLOBOOST Kit	SB-1	*			$59.00
MULTIBOOST Kit	MB-1	*			$80.00
CARBOOST Kit	CB-1	*			$62.00
BASICBOOST Kit	BB-1	*			$30.00
Accessory Harness	AH-1			*	$21.00
Battery Clip Harness	BCH-1		MB-1		$17.00
Extended Battery Clip Harness	EBCH-1		SB-1,CB-1		$31.00
Extender Harness	EH-1		MB-1		$35.00
Extended Vehicle Harness	EVH-1		CB-1		$31.00
Vehicle Harness	VH-1		SB-1,MB-1		$28.00
Fuse Block Harness	FBH-1			*	Call

A= Complete Kit
B=Component Found In Kit
C=Not Found In Any Kit

Order Specifications:

Shipping:

	Average package weight is 3lbs (1.67Kg) (1 Kit + Packaging)
	Shipping in Canada is approx. $10.00 - $15.00 (w/insurance)
	Shipping to the USA is approx. $20.00 -$30.00 (w/insurance)
	Other shipping options are available upon request.

Payment:

	Payments by check require clearing prior to shipment
	Payments by Certified Funds are shipped within 24 hours of receipt
	Payments by Credit Card (PayPal) are shipped within 24 hours of confirmation

Preferred Shipping
Method of Payment
Preferred Contact

Comments/Special Instructions

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All CYCLEBOOST kits are hand made in from materials from and designed by a guy of descent!