Name:

E-Mail:

Address:

      NOTES: Please put the shipping address if different in the Comments section below. Need this for quoting shipping fees.

City:    State:      ZIP:                    

Phone:

Model Prices: VBB - $4,835 VBC - $4,435 VLB - $4,535 See all models  Note: Includes new 5-port motor.

Any Year: or Specify: First YR Choice   Second YR Choice

Please enter a date between 1961 and 1971 only.

Bike Color:   Primary color for two tone orders.

Add $200.00 USD for Two Tone Color

Choose Two tone Option Code: Pick One OptionNone OptionA OptionB OptionC OptionD OptionE OptionF See Two Tone Option Codes

 Put Option "F" Two-Tone requests, if selected, in the Comments Section below.

Seat Style (dual seats is standard): Dual Seats Full Seat No charge for single seat

Seat Color (Black is standard): Black Brown White Full Leather may be available - see below.

Hand Grip Color: Black Brown White Black is standard

Hand Lever Style: Stiletto Plastic Coated Stiletto Silver Alloy is standard

Spare Tire Mounting: Front Legshield Rear Rack Rear Bracket Front inside Legshield is standard

Delivery via FedEx NTL Ground - Estimated at $350 depending on location.

Options (Check to select Yes to add each item - blank NO is default):

- Front Glove Box - Add $70.00 USD (Note: Spare Tire bracket behind passenger seat)

- Front Stainless Steel Rack - Add $80.00 USD

- Rear Stainless Steel Rack w/Tire Holder - Add $120.00 USD

- Rear Stainless Steel Rack w/o Tire Holder - Add $100.00 USD

- Full Stainless Steel Legshield Trim  - Add $80.00 USD (covers Legshield and floorboard)

- Half Stainless Steel Legshield Trim - Add $60.00 USD (covers Legshield only)

- Front/Rear Stainless Steel Crash Guards - Add $100.00 USD

- VBB Legshield Wings - Add $25.00 USD (available for VBB model ONLY)

- Chrome Mirror - Add $40.00 USD each (comes with brackets - specify quantity in Comments)

- Whitewall Tires (3 NEW SAVA whitewall tires) - Add $150.00 USD

- Real Leather Seat - Add $60.00 USD (same price for single full size seat or 2 seats)

- Stainless Steel Sport Muffler (2 slim output pipes) - Add $140.00 USD

- Tuned Muffler - Add $120.00 USD

Comments (Enter below): Put ship "TO" address here if different and Option "F" Two-Tone colors