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Customer Information
Name
*
First
Last
Address
*
Street Address
Apt, Suite, Bldg. (optional)
City
State / Province / Region
Postal / Zip Code
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Republic
Chad
Chile
China
Colombi
Comoros
Congo (Brazzaville)
Congo
Costa Rica
Cote d\'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor (Timor Timur)
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia, The
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, North
Korea, South
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepa
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Country
Mobile Phone
*
Other Phone
Fax
Email Address
*
Vehicle Information
Year
Make
Model
Vehicle Use
Tell us what you use it for; Racing, street, pulling, rock crawling, etc.
Weight With Driver
enter in pounds.
Transmission Type
Flex Plate Size / Bolt Pattern
Mid Plate Thickness
Please Select
Zero
.090
.120 - 1/8
.186 - 3/16
.250 - 1/4
.312 -5/16
.375 - 3/8
.500 - 1/2
Input Shaft
Valve Body
Please Select
Footbrake
Transbrake
Transbrake - Brand
*
If you entered Transbrake, please enter the brand here.
Low Gear Ratio
Current Stall
Engine Size
Engine Type
Carburetor
Injection
Peak Torque
@
RPMs Peak HP
at
Power Adders
(NOS, etc.) not included above, include # of stages and approximate HP
Blower/Turbo Info
Type
Boost
Cam Lift
Intake
Exhaust
Duration @ .050 intake
Exhaust
Lobe Center Line
Lobe Separation
Head Type/Flow
Fuel Info
Fuel Type
Please Select
Alcohol
Gasoline
Tire Info
Tire Manufacturer
Rear Tire Size
Tire Rollout
Currrent ET Info
1/8 Average ET
MPH
1/4 Average ET
MPH
60 ft
Other Info
Gear Ratio
Launch RPM
Shift RPM
RPM thru Lights
Enter RPMS at distance. Example: 7500 @ 1/4 mile , 7000 @ 1/8 mile.
Additional Questions or Comments
Feel free to let us know anything extra that you think relevant to your request. The more we know, the better we can serve you.