eZanes

After completing this form you will receive an email confirmation indicating that your claim was received. If you do not receive an email confirmation within four hours, your information may not have been submitted properly and will need to be resubmitted. If you continue to experience technical difficulties, please email eZane's at info@ezanes.com.


First Name

Last Name

E-mail Address

		As our way of saying thank you and to help you get started, we're giving you $5.00 to spend at BikeShop.com. Act now and get your BikeShop.com products when your bike ships. Get an additional $5.00 by providing us with a commercial shipping address. *

Address Type

Shipping Address



City

State

Zip Code

Phone

Comments


Please note that all bikes will be shipped in a men's (unisex) frame unless otherwise specified. Contact us directly with any questions you may have regarding your bike.

Your Height		feet inches

Your Inseam		inches
		(On a pair of pants that fit well, measure from the center of the crotch to the bottom of the leg.)

Head Circumference		inches
		(If your bike package includes a helmet, using a tape measure just above the eyebrows, measure the distance horizontally around your head.)


If you received a fit letter, please copy the information in the lower left corner of the letter into the following required fields.
If you received a paper gift certificate, please enter '1' of '1' in the 'Unit of Total' fields, and the certificate number from the bottom right corner of your certificate in all remaining fields.

Bike Model

Premium Co

Unit of Total		of

PO No.

Confirm PO No.
		(Please re-enter the PO Number to assure it was entered accurately.)

Your bicycle has been fully assembled and test ridden by a certified mechanic in our facility, when it arrives you will be responsible for some minor reassembly. We will provide you with step-by-step instructions as well as the necessary tools. The reassembly is a simple, 4-step process that generally takes just minutes to complete. If you should have any problems during the reassembly process or any questions concerning the fit of your bicycle, please don’t hesitate to contact Zane's at info@ezanes.com or by telephone at (203) 488-2453.

* Delivery of your bike will be delayed if you specify a commercial address but ship to a residential address.