Chicagoland Bicycle: Order Form by Fax or Mail

If you would rather fax or mail in your order, please feel free to use this form to expedite you order.

All orders are processed the same day that we receive them. Thank you for your business.

Ordering Information

First Name:
Last Name:
E-mail Address:
Address:
Address:
City:
State:
Zip/Postal Code:
Day Phone:	() Ext:
Evening Phone:	() Ext:

Shipping Information Fill out below if different shipping address:

First Name:
Last Name:
Company:
Address:
Address:
City:
State:
Zip/Postal Code:
Phone:	()

Additional Shipping Information: All orders are sent UPS.




Payment Information:
Card Type:	[ ] Master Card: [ ] Visa: [ ] Discover: [ ]
Card Number:
Expiration Date:	/ (mm/yy)
Name of Cardholder:

Order Information

Additional Information

Handlebar Size:

Stem Size:

Front Derailleur: Braze-on or Clamp-on - Size:

Crank Length: Chainring:

Bottom Bracket: Italian or English

Cassette Ratio: