A-1 Performance Trans & Converters Pre-Order Form

Product Pre-Order:

Customer Information

Name:

Address:

State:

Phone (Home):

Phone (Mobile):

Company:

City:

Zip:

Phone (Office):

Email:

Vehicle Information

Year:: Make: Model/Body Style:

Race classification - sanctioning body:: Current converter stall:

Average Performance (speed/ET):: Weight w/ driver:

Application:: Elevation:

Rear Suspension:: (spring type - traction bar type)

Weight Distribution:: (front/rear)

Rear End:: (type/ratio)

Rear Tire:: (diameter - width - type)

Chassis Modifications:: Current shift point RPM: Finish Line RPM:

Engine Information

Type:: Displacement: Bore/Stroke:

Rod Length:: Compression Ratio: Type Cylinder Heads:

Camshaft:: (manufacturer/model no.)

Specs:: (lift intake/exhaust) (lobe ctr.)

Duration (intake):: at .050": (exhaust): at .050":

Intake manifold:: (manufacturer/model no.)

Carburetor(s):: (manufacturer/model no./cfm)

Exhaust Manifold:: (manufacturer/primary dia.)

Transmission:: (gear ratio/type)

Flywheel:: (type/bolt circle diameter)

Motor plate:: (type/thickness)