CUSTOMER INFORMATION                                                                                                   SHIP TO:
1.  Print this form or save it to your desktop.
2.  Go to www.wps-inc.com to view parts, accessories, and items to order.
3.  Write down part numbers, description, and retail prices on this form.
4.  Fill in customer and credit card information below.
5.  Specify shipping information - to us or to you.
6.  Fax this form to 541.593.1200 or Call 541-593-8889.
 _ Customer

 UAdventure MotorSports
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                                               TOTAL:  $
                                               (If applicable) Discount Code:  
  QUANTITY                PART NUMBER                                    DESCRIPTION                                                RETAIL PRICE         SUB-TOTAL           
 
     INSTRUCTIONS FOR ORDERING
NAME:             ________________________________________________________
PHONE:           ________________________________________________________
EMAIL:            ________________________________________________________
ADDRESS:       ________________________________________________________
CITY/ST/ZIP:   ________________________________________________________
VISA/MC:        ________________________________________________________
CVU:               ________________________________________________________


Signature:      ________________________________________________________
                            Credit card billing address (ABOVE) must match customer shipping address 
WESTERN POWER SPORTS PARTS ORDER FORM
Shipping costs are based on size and weight of items and not included in the above price.