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This form is to help us determine your specific needs in order to custom build a torque converter for your special application. If you have any questions, please call us at 631-218-8700.
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| CONTACT INFORMATION |
| NAME |
|
| ADDRESS |
|
| CITY |
|
| STATE |
|
| ZIP |
|
| DAYTIME PHONE |
|
| EVENING PHONE |
|
E-MAIL
CONFIRM E-MAIL |
|
| MAY WE CONTACT YOU? |
Phone
Mail
E-Mail |
| PERSONAL INFORMATION (OPTIONAL) |
| AGE |
|
| INCOME |
|
| OTHER AUTOS YOU OWN |
|
| VEHICLE INFO: |
| YEAR |
|
| MAKE |
|
| MODEL |
|
| WEIGHT |
lbs. |
| GEAR RATIO |
|
| TIRE SIZE |
|
| TIRE
TYPE |
|
|
VEHICLE USAGE |
|
|
CLASS OF RACING |
|
|
RACING SANCTION |
|
|
ALTITUDE |
|
| TRANSMISSION INFO: |
| TYPE |
|
| INPUT SPLINE |
|
|
FIRST GEAR RATIO |
|
| TRANS-BRAKE |
Yes
No |
|
ENGINE PLATE/ADAPTOR? |
Yes
No |
THICKNESS |
| FLEXPLATE SIZE |
|
| ENGINE INFO: |
| ENGINE SIZE |
cid |
CARBURETOR
FUEL INJECTOR |
|
| CFM |
|
| CAM SHAFT |
|
| RPM RANGE |
|
| COMPRESSION RATIO |
|
| INTAKE MANIFOLD |
|
| NITROUS? |
Yes
No |
Type
|
|
| TURBOCHARGED? |
Yes
No |
Type
Size
Boost |
psi |
| SUPERCHARGED? |
Yes
No |
Type
Size
Boost |
psi |
| OTHER BOLT ONS or MODIFICATIONS |
|
| PERFORMANCE INFO: |
| 60 FT. |
|
| E.T. |
|
| MPH |
|
| DYNO TESTED |
Yes
No |
| PEAK HP |
at |
| RPM |
|
|
HP FIGURES |
|
| TORQUE |
ft.lbs |
|
DATA LOGGING |
|
PERCENTAGE OF SLIP AT
FINISH LINE |
|
| TORQUE CONVERTER: |
| TC USING NOW |
|
|
TC MANUFACTURER |
|
|
CURRENT SIZE |
|
| TC STALL |
|
WHAT STALL SPEED ARE
YOU GETTING? |
|
WHAT STALL SPEED ARE
YOU LOOKING FOR? |
|
|
ProTorque PART # (if currently using) |
|
|
ProTorque SERIAL # (if currently using) |
|
|
ProTorque BUILD DATE(if currently using) |
|
| INTERNET INFORMATION |
HAVE YOU EVER ORDERED
PRODUCTS ONLINE BEFORE? |
Yes
No |
| HOW DID YOU HEAR ABOUT US? |
Specify |
| COMMENTS |
|
| QUESTIONS |
|
|
| |
| This form is to help us determine your specific needs. If you have any questions, please call us at 631-218-8700. |
