Special order form for Quadcycle kit

THE GRANNY BIKE ^TM

Special Order Information for Quadcycle Kit:

Please fill out this form when ordering a conversion kit for connecting two bicycles with dissimilar frame and wheel sizes.

Please enter your name:

First name: MI: Surname (last name):

Please give us your mailing address:

Address 1:
Address 2:
City:
State/Province: ZIP/Postal Code:
Country:

Information Required: Bike #1: Bike #2:

(A) Wheel Size (inches):
(B) Frame Size (inches):
(C) Frame Length (inches) :
(D) Manufacture and Model:
(E) Height from ground at front fork:

(F) Distance from rear axle to A under seat:

Legion:

(A) Is the wheel size as noted on the tire:
(B) Is the distance from the center line of the peddles to the top of the frame at the seat post:
(C) Is the distance from the center of the front fork at the top of the frame to the center of the seat support post:
(D) Note the manufactures name and the model number of the bike:
(E) Measure the height from the ground to the top of the bike frame at V where the front conversion kit cross support will be fasten to the bicycle.

Thank you!

sendto: 2
subject: Special order form
successpage: http://www.thegrannybike.com/quadcycles/orderform/thanks.htm
formtitle: Special order form
first: test 22 sep 07
MI:
surname:
adr1:
adr2:
city:
state/province:
zip/postal code:
country:
Wheel size bike #1:
Wheel size bike #2:
Frame size bike #1:
Frame size bike #2:
Frame length bike #1:
Frame length bike #2:
Mfr & model Bike #1:
Mfr & model bike #2:
Height from ground bike #1:
Height from ground bike #2:
Height from ground bike #3:
Height from ground bike #4:
SUBMIT: Submit Query

sendto: 2
subject: Special order form
successpage: http://www.thegrannybike.com/quadcycles/orderform/thanks.htm
formtitle: Special order form
first: test 22 sep 07
MI: rh
surname: skeldon
adr1: 126 goodfellow road
adr2:
city: Peterborough
state/province: on
zip/postal code: k9j 5x1
country: canada
Wheel size bike #1: 28
Wheel size bike #2: 23
Frame size bike #1: 21
Frame size bike #2: 20
Frame length bike #1: 34
Frame length bike #2: 33
Mfr & model Bike #1: ccm
Mfr & model bike #2: cmd
Height from ground bike #1: 25
Height from ground bike #2: 24
Height from ground bike #3: 13
Height from ground bike #4: 12
SUBMIT: Submit Query

sendto: 2
subject: Special order form
successpage: http://www.thegrannybike.com/quadcycles/orderform/thanks.htm
formtitle: Special order form
first: test 26 Oct 07
MI:
surname:
adr1:
adr2:
city:
state/province:
zip/postal code:
country:
Wheel size bike #1:
Wheel size bike #2:
Frame size bike #1:
Frame size bike #2:
Frame length bike #1:
Frame length bike #2:
Mfr & model Bike #1:
Mfr & model bike #2:
Height from ground bike #1:
Height from ground bike #2:
Height from ground bike #3:
Height from ground bike #4:
SUBMIT: Submit Query

sendto: 2
subject: Special order form
successpage: http://www.thegrannybike.com/quadcycles/orderform/thanks.htm
formtitle: Special order form
first:
MI:
surname:
adr1:
adr2:
city:
state/province:
zip/postal code:
country:
Wheel size bike #1:
Wheel size bike #2:
Frame size bike #1:
Frame size bike #2:
Frame length bike #1:
Frame length bike #2:
Mfr & model Bike #1:
Mfr & model bike #2:
Height from ground bike #1:
Height from ground bike #2:
Height from ground bike #3:
Height from ground bike #4:
SUBMIT: Submit Query

sendto: 2
subject: Special order form
successpage: http://www.thegrannybike.com/quadcycles/orderform/thanks.htm
formtitle: Special order form
first: Abe
MI:
surname: Torkelton
adr1:
adr2:
city: Boston
state/province: MA
zip/postal code: 02116
country: US
Wheel size bike #1:
Wheel size bike #2:
Frame size bike #1:
Frame size bike #2:
Frame length bike #1:
Frame length bike #2:
Mfr & model Bike #1:
Mfr & model bike #2:
Height from ground bike #1:
Height from ground bike #2:
Height from ground bike #3:
Height from ground bike #4:
SUBMIT:

sendto: 2
subject: Special order form
successpage: http://www.thegrannybike.com/quadcycles/orderform/thanks.htm
formtitle: Special order form
first:
MI:
surname:
adr1:
adr2:
city:
state/province:
zip/postal code:
country:
Wheel size bike #1:
Wheel size bike #2:
Frame size bike #1:
Frame size bike #2:
Frame length bike #1:
Frame length bike #2:
Mfr & model Bike #1:
Mfr & model bike #2:
Height from ground bike #1:
Height from ground bike #2:
Height from ground bike #3:
Height from ground bike #4:
SUBMIT: Submit Query

sendto: 2
subject: Special order form
successpage: http://www.thegrannybike.com/quadcycles/orderform/thanks.htm
formtitle: Special order form
first: LFQIwFWOuhEiBBPic
MI: NOJ
surname: ahjxkfhrg
adr1: BfNGSwJmNUrDJiTn
adr2: BvzYADXR
city: tLqburiAq
state/province: kcGkmPYGoTLcEGV
zip/postal code: IVYNtGvXJR
country: vmTRIlKWFvPTFdk
Wheel size bike #1: GdEgdFMYZV
Wheel size bike #2: nQSZBRzph
Frame size bike #1: fnEPPPRaPynLnZWWnG
Frame size bike #2: YCixDqDVbXrTGhvaO
Frame length bike #1: akCpowdBJ
Frame length bike #2: RlWecvldLbujZW
Mfr & model Bike #1: NheNTHQD
Mfr & model bike #2: FUvQCujHW
Height from ground bike #1: NieLlZQMXfCGlMr
Height from ground bike #2: DHXglGhXilSvdNMbop
Height from ground bike #3: mxMHZhzMENGEsYz
Height from ground bike #4: pOTvxGEHhZ
SUBMIT:

Skeldon Bike Co. Ltd.
126 Goodfellow Rd.
Peterborough, Ontario.
Canada, K9J 5X1
E-mail: e-mail address. FAX/PHONE No: (705) 740-0194
Copyright (C) 2000, Skeldon Bike Co. Ltd. All Rights Reserved. Patent Pending.
Last Up Dated--1 May, 2008
Note: The Granny Bike ^™ , is a trademark of the Skeldon Bike Co. Ltd..