Rider Name         ________________________

Address             ________________________

                    ________________________

Phone Number       ________________________

Email Address     ________________________

Rider Weight (no gear)      __________    Height        ________

Snowmobile Info      Year ________  Brand __________    Model _______

Last Rebuild ________   Mileage on Sled _______   Number of Shocks to be serviced _______

Type of riding     Recreational     Snowcross

Riding Skill Level     A- Pro     B - Amateur     C - Novice

Type of Trail Riding     Fast/Aggressive   Nonaggressive

Work Requested

     Rebuild            Revalve         Springs        Custom Parts  

 Other? ____________________________________

 Do you request an estimate before we begin work?  If so, please list Phone Number

                                      ___________________________

 Desired Shipping       Ground      3 Day      2 Day      Next Day     Sat Delivery 

 Where did you hear about Meiser Racing? 

      Magazine Ad          Dealership          Internet       Friend     ________________

 Signature   _________________________________________

 Please Submit the preceding information in your request for Suspension work and ship to:

Meiser Racing LLC  20 Alfred Blvd  Waconia MN 55387