Apply with TailG to get you own electric bicycles. Tell us what model, color, and payment terms and option you prefer so we can give you the best deal for your desired product. Kindly fill out the application form below and submit once done. Choose a Model * Selling Price Terms NoneTerm 1 Down Payment Monthly Installment Application Information Last Name * First Name * Middle Name * Nick Name Occupation Gender * - Select -MaleFemale Civil Status * - Select -SingleMarriedDivorcedSeparatedWidowed Address Length of Stay * Telephone Number Mobile Number Provincial Address If Rented Name of Landlord Contact Number Address If Married Last Name First Name Middle Initial Nick Name Contact Number Telephone Number Occupation Address If Employed Company/Employer Position Length of Service Address If Self-Employed Source of income Business Address CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Math question * 6 + 12 = Solve this simple math problem and enter the result. E.g. for 1+3, enter 4. Submit