Owner Information:

Full Name:   City:    State: 
Zip:     E-mail address: 

Car Restoration Services:

Vehicle Make:    Model:    Year: 
On a scale of 1 to 5 , how do you rate this car? - 1 2 3 4 5 ( Ex: 1 indicates perfect 3 indicates usable with very little visible rust and interior shows some wear, and 5 indicates not usable as is)

Application: please tell us about your application for this car (daily driver, Street Performance, race car, street/strip, etc.   Give us a good idea of what you expect to do with this car)

Special instructions:  please tell us about any custom features you'd like, such as paint color, types and color of stripes:

Interior:  please tell us about what type of interior restoration or custom feature you'd like, such as stock, color preferences, add-ins, roll cage, etc.

Additional comment for this restoration or custom car: tell us anything here not covered above, or additional services you request.

Engine Services:  (high performance engine building limited to Chevy Big block and Small block, most performance upgrades available for all domestic makes and models and some foreign models)

Is this engine for the vehicle restoration above?   SELECT Yes No

If "No", please describe the application:

Engine make:  , SELECT Big Block Small Block ,  Displacement:  c.i.

What components (if any) will be supplied? (indicate current condition)

Additional comments for engine service:

Additional comments or services you require:

Optional Services:  (check all that apply)

  Trailered Pick-up service
  Trailered Drop-off service

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