WorldBikes.comTM Product Order Form

Please print this form, and then fill in all information below.

Please send this form and payment to:

Worldbikes.com
P.O. Box 286
East Lyme, CT, 06333


Make checks payable to WorldBikes.com. Thank you for your business!


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				         Date:______/______, 20_____

Mailing Address:

Name _______________________________________________________________


Address ____________________________________________________________


City _____________________________  State _______  ZIP _____________




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Quantity    	Item Description		Cost Each        Shipping*
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  ____		Motorcycle Dealer Directory	   $35		  $3.95    



(CT residents add 6% sales tax for each copy)	      $_________________


                                               TOTAL: $_________________

Check No.(if paying by check) __________
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