Order Form

Electrik Motion- Quick Links

^{ELECTRIK
MOTION}

^866-ESCOOTR ^{(TOLL FREE
1-866-372-6687)}

^{" Quality
Electric Bikes & Electric Scooters!"}

Please use this order form to complete your order.

When done click the submit button below!

Please fill-in all fields as incomplete orders cannot be processed.

^{^{WE
ACCEPT}}

Please provide the following contact information:

Name

Work Phone

Home Phone

E-mail

Billing Address
Address (cont.)
City
State/Province
Zip/Postal Code

Shipping address

	SHIPPING
Ship to Address
Address (cont.)
City
State/Province
Zip/Postal Code

Billing Information

	BILLING
Credit Card
Cardholder Name
Card Number
Expiration Date

^{^{WE
ACCEPT}}

Please provide the following ordering information:

QTY DESCRIPTION PRICE

Please click the submit button below. If you prefer you can call your order in toll free to 866-ESCOOTR(372-6687) or 845-639-9046(USA). NYS residents please add sales tax. All internet orders will be confirmed by callback prior to processing.

Thank you for your business!

Terms & Conditions- 15 day money back guarantee subject to a 25% restocking charge. Shipping & handling is non-refundable. This assumes that the bicycle/scooter is unused and returned in original packaging with all provided materials. Please call for a RMA prior to returning.

The Future Awaits You, Get ELECTRIK!!!!. Copyright © 2000 (ELECTRICK MOTION]. All rights reserved. Revised: November 30, 2005

The Future Awaits You, Get ELECTRIK!!!!.
Copyright © 2000 (ELECTRICK MOTION]. All rights reserved.
Revised: November 30, 2005