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.)
E-mail
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:
Comments:

SHIP TO:

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