Rider Input & Quote Form

Note: This is an unsecured form, do not click the submit button if credit card info is filled out.  Print the form and include when shipping your components.

Rider name
Weight w/o gear Height
Shipping address
City State
Zip Code
Home phone (include area code)
Work/day phone (include area code)
(Necessary to ensure we can contact you if there are any questions during service.)
Referral Source
Bike year Brand
Model Size
Primary type of riding
Ability Typical Finish
Fork Service:
revalve rebuild oil change other
Fork Products:
anti-bottoming system internal bleed springs Ultra Adjusters
Fork Mods:
hard coat anodize internals titanium nitride legs shorten travel
Shock Service:
revalve rebuild oil change other
Shock Products:
heavy duty bumper ultra adjuster spring
Shock Mods:
hardcoat anodize titanium nitride shaft shorten travel
Payment method: cash check COD credit card
Credit Card Payment:

Card # Exp
Shipping: Shipping rate:


C-Cycle Suspension Service
16 West High Street
East Hampton, CT 06424