MAIL ORDER FORM MOTO-CYCLE PARTS INC. CUSTOMER PROFILE CUSTOMER NAME _____________________________________________________________________________________ ADDRESS____________________________________________________________________________________________ CITY_________________________________________________________________________________________________ STATE______________________________ ZIP ______________________________________________________________ TELEPHONE__(_______)____ _____________________CELL___________________________________________________ EMAIL ADDRESS_______________________________________________________________________________________ PARTS & ACCESSORIES REQUISITION INFORMATION YEAR_____________ MAKE________________________________________ MODEL________________________________ ENGINE CC’S____________ ATV ______ SNOWMOBILE _________ DIRT ________ STREET _______ CRUISER __________ TYPE OF PART REQUESTED______________________________________________________________________________ QUANTITY_______________ DESIRED PRICE RANGE__________________________________________________________ HOW SOON IS PART NEEDED_____________________________________________________________________________ IMPORTANT PART SPECIFICS SUCH AS COLOR, LEVEL OF PERFECTION ETC… ______________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________ Thank you for your business. Used parts availability changes everyday All prices negotiable. P. O. Box 500 DeSoto, Ia 50069 Phone: 515-834-2786 FAX: 515-834-9023 |
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