EmailMe Form - Warranty Application form

Shop Name *

Contact name *

Account Number

** Staff use only

Address *

Street Address City State / Province / Region Postal / Zip Code

** Need not fill this out if you are an account customer

Email *

Phone *

Date of purchase *

DD / MM / YY

If brand new and unsold, put todays date

Brand *

Model *

Failed Part *

Serial Number

Please include any serial numbers visible

Failure / Fault description *

Proof of purchase *

For bikes that are NOT brand new.

Part Image *

Failure Image

Extra File Upload if needed

Sales Rep

James Huang

Jason Eve

Matt James

Heinrich Stroebel

Nathan Bradbery

Craig Brown

If you want your sales rep CC'd into this warranty process, check the name of your sales rep. This is not required.