SHORT BOARDS      

  FUN SHAPES      

  LONG BOARDS      

  FISH      

  FINS      

  ORDER FORM 

  To order your custom Basic Element Surfboard, please print out this form and
  fax or mail it to:
  Basic Element Surfboards
  740 Prospect Ave.
  Pine Beach, NJ 08741
  Fax: 732.341.4191  ___________________________________________________________________________________

  Name:                                                                                     Date:
  Address:                                                                                 Height:
                                                                                                Weight:
  Phone:
  Years of Surfing Experience:
___________________________________________________________________________________

  Please describe the type of surf you will be using your board in:

  Board Description
  Shape:
  Length:
  Width:
  Thickness:
  Nose width (choose one): Narrow     Regular     Full
  Tail width (choose one): Narrow     Regular     Full
  Describe the type of surf you will using your board in:

  Glassing (choose one): Ex-Lite     Standard     Strong

  Fins (choose one): FCS     Glass     Future

  Color Design
  Top:
  Rail:
  Bottom:
  Please draw in your color and logo placement:

  Please allow 6 weeks delivery upon receipt of deposit.

P: 732-341-7507 F: 732.341.4191  
740 Prospect Ave.   Pine Beach , NJ  08741  
megcimo@aol.com