HOT HEADS Research & Racing, Inc. Printable Order Form

Order by Part Number (P/N) and Description. If you need more space, please continue on a separate sheet of paper.

	Hot Heads Products	Price
P/N 1	Part	Price
P/N 2	Part	Price
P/N 3	Part	Price
P/N 4	Part	Price
P/N 5	Part	Price
P/N 6	Part	Price
P/N 7	Part	Price
Merchandise Total: $ NC Residents Add 7 % Sales Tax: $

Shipping & Handling Costs will be added to your order total. If you would prefer to know the shipping charge before you place your order or if you are paying by check, please e-mail or phone HOT HEADS for the actual shipping costs.

Please enclose a check or money order for your total or complete the following credit card information (fax or postal mail).I authorize Hot Heads to charge my order total to my (circle one):

MasterCard VISA Discover	Account Number: Security Code	Expiration Date:
Authorized Signature:

Name::

Address:

City/Province

State/Country

Zip or Postal Code

Phone Number

E-mail Address (optional):

Mail your order to: Hot Heads Research & Racing, Inc.
392 Walker's Hollow Trail, Lowgap, NC 27024
or fax to: (336) 352-3892

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