Cylinder Express
  2/4 Stroke Cylinder Repair
  Unique Technology
  Endorsements/Links
  Order Forms
  Off Road Bikes
  Karts
  Snow Mobiles
  Liners
  Motorcycles
  Max Power RPMs

 
RACE REPAIR / SERVICE ORDER FORM

APTEC Ltd
Southbrook Road
Gloucester GL4 3DN


Please print this form, complete and include with your cylinders.

NAME:
TEL:
ADDRESS:


POSTCODE:
E-MAIL:
DATE SENT:
DATE NEEDED:

BIKE INFORMATION:
MAKE:
 MODEL:
 YEAR:
  
Please supply me with the services and or parts specified below:
 
Cylinder Plate & Hone to Stock size Weld Repair (additional £30.00)
Wiseco pro-Lite Piston Kit   Hone Repair only (additional £20.00)
Top End Bearing   Cometic Gaskets
CYLINDER EXPRESS      
Xtreme Piston: Size & Part No ............................................................. Quantity .............
2 Stoke Cylinder porting:  (additional £55.00) 
LOW to MID Porting    
MID to TOP Porting    
All over performance Porting    
Additional Services
Signature:  Print:
 Date: 

  

OTHER INFORMATION: (please provide as much information about your jetting,
gearing, and aftermarket add ons - such as pipes, silencers, reed cages etc.)

  
  

PAYMENT METHOD:
On receipt of your cylinder or parts we will send you a proforma invoice. We accept payment by Visa (by phone or email) or by cheque (4 day clearance).

I would like to pay with: (please check one)
  

VISA  (Please enter your card
details and sign below)
CHEQUE   
  
Cardholder's Name:
Card Number:
Expiration Date:
3-Digit Security Code:
  
I authorize Aptec Ltd. to charge for services received:
  
Cardholders Signature:
   
 
Please remove below label and adhere to box when shipping (cover with clear tape)
----------------------------------------------------------------------------------
APTEC Ltd
Southbrook Road
Gloucester
GL4 3DN
----------------------------------------------------------------------------------


   
 
 
 
  Click here if you would like us to keep you informed of new products and new developments by email.  
 
 
 
Site Map  Home  Top  
Web Site Design
Midland Alpha

 
Primary communication point:
Telephone: 01452 300800
Fax: 01452 500400
Email: aptec@poeton.co.uk
Web: http://www.poetonaptec.co.uk
APTEC Ltd
Southbrook Road
Gloucester
GL4 3DN