PAV3- Personal Activity Vehicle Side by Side Team Dual Trike Adult Lite Trike

Request for Information Worksman Cycles for Special Needs Use

So many people now use Worksman tricycles for special needs applications. It is very rewarding for us to get all the great feedback from families, health care professionals and others detailing the wonderful experiences that special need riders have enjoyed. As America’s oldest and largest adult tricycle manufacturer, we are able to provide high quality cycles at very reasonable prices (unlike those companies that "specialize" in the special needs market). We also are known for making the most durable cycles on earth, so many of our models are appropriate for heavier riders.

Please complete the form below so we may assist you in determining the right choice for your particular riding needs

Please provide the following contact information:

First Name

Last Name

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Country

Home Phone

FAX

E-mail

Are you interested in Worksman Pleasure Cycles for yourself or someone else?

Myself
Someone Else

Please describe the nature of the Special Needs Application?

Is this cycle intended for independent or "team" riding? Please select:

Is an electric power assist required for the rider ?

Yes No

Please provide a brief description of riding goals.

Please provide this information describing the rider:

Age

Height

Weight

Are you interested in purchasing this cycle within the next 30 days ?

Yes No

Would you like to have a Worksman sales representative or a Worksman Cycle dealer call you ?

Yes No

How did you find out about Worksman Special Needs Cycles?

Would you like to receive a written price quote?

Yes No

To speak to a Worksman Customer Service Team Member, please call us M-F 8:30-5 Eastern time at 800-962-BIKE (2453)

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First Name
Last Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Home Phone
FAX
E-mail