Please be sure to fill out this form completely. If you have any questions feel free to e-mail us or give us a call during office hours at 215-781-1370.

Contact Info

Contact Name

Company Name

Address

City, St. Zip

Daytime Phone

Evening Phone

Fax

e-mail Address


Use Of Vehicle

Street %

Towing

RV

Drag Strip %

1/4 Mile

1/8 Mile

Off Road %

Circle Track

Dirt

Asphalt

Track Size

Miles


Engine Info

Engine Size

Cubic Inches

Horsepower

Comp. Ratio

Bore

Stroke

Rod Length

Valve Size

Intake

Exhaust

Cylinder Head Type

Comb. Chamber C.C's

Cam Make

Number

Duration at .050

Intake

Exhaust

Hydraulic

Solid

Roller

Flat Tappet

Lobe Center

Intake

Exhaust

Seperation

Valve Lift

Intake

Exhaust

Rocker Arm Ratio

Intake

Exhaust

Ignition Make

Box #

Is Adv. Locked Out

Yes

No

Crank Trigger

Yes

No

Intake Manifold Make

Model

Port Work

Yes

No

How Many Spacers?

Bolt Pattern

850

Dominator


Misc. Info

Describe Exhaust System

Gear Ratio

Tire Size

Transmission Make

Gear Ratio

Trans. Brake

Yes

No

Torque Converter Make

Stall Speed

1st Step R.P.M.

Shift R.P.M.

Max R.P.M.

Does car use thottle stop?

Yes

No

If so what brand?

Fuel Pump

Fuel Regulator

Click on the Send button to send us the form.

Click on the Clear button to reset all fields.