Print This Form, Fill It Out Completely,Check The Appropriate boxes, and
include it with Cylinder or Crankshaft. Please Print Clearly
500 Parkson Rd. Unit B
Henderson, NV. 89011

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________________   ProX pistons are supplied by default
[  ]  Prefer Wiseco Piston add $20.00
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).Additional charges may apply to remove