Central Wheel Components Limited

Wheelbuilding Classic Rims Spokes & Nipples Powder Coating ** Price Lists ** ** Order Form **

Please use this form to place an order with us. If you have any queries then please email us first.

Please supply us with a daytime telephone number where we can contact you if we need further information.

CONTACT DETAILS
(Please complete ALL Fields in RED !)

	CARD HOLDER ADDRESS (Use Address As On Your Credit Card Statement - Including Postcode)
Name
Address
Address
Town / City
County
Postcode
Daytime Telephone
E-mail


	DELIVERY ADDRESS (If Different From Card Holder)
Name
Address
Address
Town / City
County
Postcode

	BIKE DETAILS
Bike Model
Bike Year
Front Hub
Rear Hub

ORDER DETAILS

PROCESS REQUIRED & DETAILS
(Please tick as appropriate)

Rim & Spoke Respoke Tension & True Other

FINISHING REQUIRED & DETAILS
(Please tick as appropriate)

Blast Polish Powdercoat Skim Drum Other

Tyres
(Please tick as appropriate)

Supply New Tyres Refit Old Tyres Keep Old Tyres

Other
(Please tick as appropriate)

Parts To Keep Keep Old Rims Other

CREDIT CARD PAYMENT

Please either leave a contact daytime number and we will contact you for payment or alternatively fax your order through to us (with card details) on 01675 466412.

PAYPAL PAYMENT

If you wish to pay us via PayPal then please mention this in the order box above and we will send you a pro-forma invoice along with our PayPal details.

TELEPHONE PAYMENT

Of course you can also telephone your order through to us on 01675 462264.