Print This Form, Fill It Out Completely,Check The Appropriate boxes, and include it with Cylinder or Crankshaft. Please Print Clearly

Job Order Form     Print Clearly
Name                                                                              Email
Street Address
City                                                                                  State                                       Zip
Day Phone with Area Code
Vehicle Make                                    Model                                        Year
Check Appropriate Box for Work Needed
[  ]  Steel Sleeve                [  ]  Other specify__________________________________________    
[  ]  Re-Nikasil
[  ]  Big bore Kit     Specify size________________   Wossner pistons are supplied by default
[  ]  Prefer Wiseco Piston add $30.00
Optional Parts or Service Requested
[  ]  Top End Bearing                                                        [  ]  Rebuild Crankshaft
[  ]  Top End Gasket Set                                                   [  ]  Wrist Pin
[  ]  Bore to Next Oversize                                               [  ]  Hone Only
Return UPS shipping Preference
[  ]  Next Day                                                                       [  ]  Two Day
[  ]  Three Day                                                                     [  ]  Ground
Payment Method
[  ] Master                        [  ]   Visa
Card#_________________________________ Exp. Date     mm/yyyy____________________
Name on Card________________________________________________________________
Billing Address________________________________________________________________
Ship To Address if other than bill to
City                                                                              State                                    Zip
Signature X_________________________________________________________________
Additional charges will apply to remove parts left on cylinder (studs, powervalves, covers,
intake, etc). Any parts left over 30 day’s will be sold.