* Cylinder Head Manufacture:_____________________________________________
* Application: Chevrolet 15 bolt _____ 18 bolt _____ head
GMC
_____
* Casting/Serial Number (if applicable):
___________________________________________________
* Current Owner's Name:
______________________________________________________________
* City, State:
______________________________________ Phone Number ______________________
* History/Previous Owners/Racing Accomplishment(s): use
back as needed
* Current Usage of Cylinder Head and/or Plans for
Usage: use back as needed
* "Last Time/Year" Cylinder Head
was Used:
* Type of Intake Assy(s):
* Type of Exhaust Assy(s):
* Type of Valve/Side Covers:
* Catalogs/Literature:
* "Other" Types of Unique Equipment:
* Comments/Remarks:
SEND TO:
Mark Plunkett, ATTN: 12 Port
Registry
PO Box 751, Berwick, VIC 3806
AUSTRALIA 03-97689884
NOTES: Use attachments as required.
All information will be available to the Inliners International membership and
posted to the Registry online unless requested otherwise. We strive to
maintain privacy and will only put the minimal amount of information online.
~Inliners International Thanks You For
Your Submission ~