Moto-Arts Order Form

Overseas Orders: Add $35.00 per order
Dealer inquiries invited.

If you prefer you may print this form, fill it out, then fax it to: (818) 957-1059

Or mail it along with a cashier's check or money order for the price of the part * to: 2712 Sanborn Ave., La Crescenta, CA 91214
Include a cashier's check or money order for the full price of your order.
* Add 8.50% sales tax if you are a California Resident.

Name (First, Last)
Address
City/State
Postal Code
Phone #
Fax
e-mail

Model & Size	Finish	Price each	Quantity
*HEAT SHIELDS* Aluminum with a polished or plated finish
*EXHAUSTED 15 inches*
	Polished Aluminum	$245
	Chrome	$245
	24 Karat Gold	$290
	Black Nickel	$290
*TAILWIND 13 inches*
	Polished Aluminum	$245
	Chrome	$245
	24 Karat Gold	$290
	Black Nickel	$290
*RE-ENTRY 8 inches*
	Polished Aluminum	$245
	Chrome	$245
	24 Karat Gold	$290
	Black Nickel	$290
*FLAMING RAPTOR 14 inches*
	Polished Aluminum	$245
	Chrome	$245
	24 Karat Gold	$290
	Black Nickel	$290
*DEADHEAT 14 inches*
	Chrome	$290
	24 Karat Gold	$245
	Black Nickel	$290
*DEADHEAT DUAL COLOR 14 inches*
	gold scull/ chrome flames	$300
	gold scull/black nickel flames	$300
	chrome scull/gold flames	$300
	black nickel scull/gold flames	$300
After pressing submit you should mail a cashier's check or money order for the price of the part(s)* to: 2712 Sanborn Ave., La Crescenta, CA 91214 * Add 8.50% sales tax if you are a California Resident You will receive an email confirmation within 24 hours.