Premium Foam Conversion Order Form - Instructions
Use PRINT and COMPLETE this form when sending your BMW OEM seat to Sargent for a premium foam conversion product installation.

1. Fill out section [A] of the order form. No Post Office Boxes Please!  We can only return your seat to a street address. DAYTIME phone number is critical if we have questions.

2.  Complete your order details in section [B].  IF YOU HAVE ALREADY SECURED YOUR ORDER BY PHONE or E-COMMERCE - please skip step 3 and section [C].

3.  NEW ORDERS ONLY - Complete the Method of Payment in section [C].  If you have already secured your order with a credit card by phone or e-commerce, then you may skip this step.

4. Attach the order form and any special instructions to the seat.  Box up the seat and ship to:
Sargent Cycle Products, 1036 Hubbard Street, Jacksonville, FL 32206.

NOTE: It should be inexpensive to ship your seat by ground transportation, especially if you box it yourself and take it to a U.P.S. or U.S. Post Office outlet. Packing and shipping companies are more convenient, but charge accordingly.

Section [A]

[    ] New Order

[    ]  Phone Order
Order Date:_________

 [    ]  E-Commerce
Order #: ____________

Return Seat To:

NAME:
(FIRST, MI, LAST)
 
COMPANY NAME:
(IF APPLICABLE)
 
APT or SUITE #::  
STREET ADDRESS:  
CITY, ST, ZIP  
DAYTIME PHONE:  
EMAIL ADDRESS:
We will email return UPS
shipping confirmation, if desired.
 
Premium Foam Conversion for the 2001+ F650GS / F650GS Dakar
Premium Foam Conversion for the 2009+ G650GS
Year:  
Colors:  

PLEASE DON’T FORGET TO ATTACH THIS ORDER FORM TO THE SEAT!

1036 Hubbard Street Jacksonville, FL 32206 • 1-800-749-7328 / 904 354-4531 • FAX 904-354-7979 • www.SargentCycle.com

Section [B]

For All Orders:
Seat Height Version        [   ]  High  PFC-527       or          [   ]  Low  PFC-544
Standard Upholstery Choices (check one):
[   ]   CarbonFX Inserts, Black Welt and Black Trim

$374.95

[   ]   CarbonFX Inserts, Silver Welt and Black Trim


- OR -
Non-Standard Upholstery
* Choices:
[    ]  CarbonFX Inserts

[   ]   Color Welt - Please specify color: ____________________

$394.95

Other Options:  
[    ]  Leather Inserts Front & Rear*          Daytona     or      Smooth

$55.00

[     ]   BMW M-Sport Detail*

$30.00

*Restocking fees apply to non-standard upholstery configurations and upgrades.  
   
   

Return Shipping and Handling (UPS GroundTrac Continental USA only).

$19.95

Limited USPS Service is available for PO Box and Military Addresses Only - $40.00
*Additional Shipping Charges may apply to large touring seats, oversized seats,
shipping to Alaska or outside the continental United States - CALL FOR PRICE.

 

Sub-Total (Florida Residents - add local county sales tax)

 

TOTAL

 

 

 

 

Section [C]

For New Orders Only:
Method of Payment
[ ] Money Order [ ] Personal Check (NOTE: Will be held of 11 days.)
Credit Card: [ ] Discover [ ] MasterCard [ ] VISA [ ] American Express
Credit Card #: __ __ __ __ - __ __ __ __ -  __ __ __ __  - __ __ __ __
Name (as it appears on the card):
Authorized Signature:
Expiration Date: __ __ / __ __
Billing Address:
City, ST, ZIP:
Home Phone:

Sargent Cycle Products North America
1036 Hubbard Street Jacksonville, FL 32206 • 1-800-749-7328 / 904 354-4531 • FAX 904-354-7979 • www.SargentCycle.com