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FILL FORM OUT COMPLETELY AND FAX BACK TO (661)
723-1521
Type of Racing: Circle your application: Street Performance --
Drag Racing -- Circle Track
Off Road -- Marine -- Mud Drags --- Sand Drags
Engine:
Size: _____ ci. Compression Ratio:________ to 1. Dyno Tested:
Yes____ No____
Peak HP:________ to ________RPM Approx. Torque:________ ft. lbs. at
________RPM
Cam Specs: (Intake) Lift________
Duration________
@.050: (Exhaust)
Lift________ Duration________
Specified Cam RPM (Power) Range __________ to_________
Carb. Setup: Size: ________Cfm Qty: 1 _____ or
2________ Alco/Gas: ____________
Nitrous: _____No _____ Yes Added HP: 1st stage _____ 2nd
stage________
Blower _____ Yes _____No Make: ______________________
Size: __________
Manifold: ______ Cast _______ Sheet Metal _______ Other
Type Cylinder Heads: _________________________________________________
Trans:
Type:____________________ 1st gear ratio: __________ Input spline:
_________
Trans-brake: ____ Yes ____ No Flexplate Size: ______ # teeth/dia.
Bolt hole Dia. ____ in.
Vehicle:
Type: _________________________________________Weight
(w/driver):__________lbs.
Rear axle ratio:___________ Tire size: ______ Dia. X ________ Width
Shifter Type:_________________ Mid-plate: _____ No ______ Yes Thickness:
_________ in.
Operation: Starting line RPM:
________________ Shift point RPM: ______________
Class:_________________________________________ Track length:
______________
Recommendation:
_________________________________________________________________________
A 50% DEPOSIT IS REQUIRED ON ALL ORDERS.
IF WE DO NOT RECEIVE A DEPOSIT AT THE
TIME WE RECEIVE THIS FAX THE ORDER
WILL BE PUT ON HOLD!
Form of payment: Type of card: M/C_____ VISA _____
DISCOVER ________
Credit card # _______-______-______-_______ Exp. Date
__________
Customer Information: Name:
______________________________________Phone# __________________
Address:
_________________________________________________________________________________
City: _______________________________________________ State _______
Zip code _________________
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