This order form is a FAX 435-687-9239 or snail mail your order to us
Today's Date:                    

Year & Body Style of Car:
Your Name:
UPS ship to/Del. address
City/State/Zip
AC & Phone#
PRINT Your EMAIL address:
Card Billing Name:
Card Billing Address:
Card City/State/Zip:
Card AC & Phone:

We accept Visa, MasterCard, Discover. Place the 16 numbers below & Expiration date. 
_____________/______________/_______________/________________/exp.______/_______

Please sign your name here:________________________________________V-Code______
 

Name of Part

Item #  

Price of Part
     
     
     
     
     
 

 

  
 

Sub-Total

  
 

Shipping

  
    MADE IN THE USA~Total Amount Due USA FUNDS ONLY  $  

We pay UPS ground on FULL WOOD KITS in the 48 states. You pay for UPS for individual items.

Utah residents must pay 6.35% sales tax

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