PLEASE FILL OUT AND SUBMIT Name (Company Name) * First Name Last Name Email * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country PHONE# Specify Make & Model of Chair * SELECT A TUBE DIAMETER FOR WHERE YOUR LEVER WILL MOUNT (IN INCHES) TUBE DIAMETER * 3/4'' (0.75) 1'' (1.00) [TILITE: AeroT, TRA, TR] 1-1/8'' (1.125) 1-1/4'' (1.25) [TILITE: AeroZ, ZRA, ZR] SELECT WHEEL MODEL (SPYNERGY) WHEEL MODEL * CLX BLADE LXL LXL LX XLX XSLX SLX-24 spk. XSL SL SLX-18 spk. SPOK EVERYDAY Thank you! THANKS FOR CHOOSING PushLOX AS YOUR PREFERRED LOCKSWE WILL EMAIL YOU YOUR QUOTE AND PAYMENT OPTIONS.
