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Alpine Designs Order Line: 208 . 263 . 9373 or email

CUSTOMER NAME:_____________________________________

CUSTOMER PHONE:____________________________________

CUSTOMER EMAIL:_____________________________________

WORKSHEET:

Section A: Please record the following measurements from your best fitting or current bicycle

Section B: Please record the requested measurements of your body

A: Present dimensions of riders' (circle one): Best Fitting Bicycle, Fit Kit/Size Cycle, Your Dream Bike:

1.) Seat Tube Length (C -C) ______mm (C - T) _______mm

2.) Head Tube Length (total length)__________________mm

3.) Top Tube Length Actual (center of head tube to center of seat tube)________________mm

4.) Top Tube Length Effective (stem bolt to center of seat post)_______________mm

5.) Stem Length and Angle (center of bolt to center of handlebar)________mm x_____deg

6.) Head Tube Angle (with protractor)______________deg

7.) Seat Tube Angle (with protractor)_______________deg

8.) Bottom Bracket Height (center of crank bolt to floor)______________mm

9.) Crank Arm Length (center of crank bolt to center of pedal)_____________mm

10.) Wheel Size ______________ Tire Size _______________

11.) Make _________ Model __________ Year _________

Material__________ of current bike

B: Rider Body Dimensions: *note: measurements should be taken when wearing cycling shorts and socks

1.) Height ____________CM

2.) Weight ___________ LBS

3.) Inseam Length (see drawing):_________mm

4.) Torso Length (see drawing): _________mm

5.) Arm Length (see drawing): _________mm

6.) Shoulder Width (outside of one shoulder to the other): _________mm

7.) Shoe Size: __________USA

8.) Flexibility: 1 2 3 4 5 6 7 8 9 10

Another person should take all measurements. Do each twice and average the results.

CONSTRUCTION DETAILS:

Please list any additional features you would like and we will quote:

Chain Hanger

Additional Water Bottle Mounts

Rack Mounts Rear

Front (low rider)

Fender (rear)

Pump peg

Top tube internal rear crake cable tunnel

Internal derailleur cable guides

Road 650c Wheels

Mtn 29" wheels

Other: ____________, ____________, _______________, _____________

Fill in the blanks, we will quote based on your selections.

FRAME:

Model _______________________________________________________

Size ________________________________________________________

Colors ______________________________________________________

Tig weld _________ Fillet brazed__________ Lugged_____________

Steel_________ Titanium___________ Carbon___________

FORK:

Model________________________________________________________

Color(s)_____________________________________________________

WHEELSET:

____________________________________________________________

BRAKES:

____________________________________________________________

DRIVETRAIN:

____________________________________________________________

TOP KIT:

____________________________________________________________

ACCESSORIES:

____________________________________________________________

Just a few questions about your riding habits:

Average miles per week _______ ,

How are you planning to use your new bike? (i.e 24 hour races, touring, xc racing, freeride, road race, etc). Use back of sheet if necessary.

Let us fill out the following info:

Initials ______ Received date______ Follow up date______

Custom geometry ______ Stock geometry _____

Paint color sku# __________ Fork sku#_________ Wheelset sku# _____

Fork sku#_________ Brake sku#_________ Drivetrain sku #________

Top kit sku#______________ Access sku#___________

Order Placed date _______ Order due date_______ Deposit received______ Balance due _______

Delivery type: Pickup________ Ship out _________ Notes: