IMPORTANT!
If mailing your order with check or money order, please call to verify current pricing!
Please call to verify shipping costs or we cannot process you order!
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PAGE QTY. PART NUMBER DESCRIPTION (please include colors) UNIT PRICE TOTAL PRICE
CLASSIC MUSCLE a division of
MODERN CHEVROLET
5415 Kelley-Moore Drive • Winston-Salem, NC 27105
(336)727-4828 • 800-722-4828 • Fax (336)727-4856
PLEASE TELL US ABOUT YOUR CAR!
Year___________Model_________________________________
Coupe_________Conv.________Sedan (post)________2 dr / 4 dr
Transmission: A/T________ M/T________ Engine Size________
Carburetor_____________________________________________
Interior color________________ Exterior color________________
PLEASE GIVE US YOUR STREET ADDRESS!
(UPS cannot deliver to a PO Box)
Name________________________________________________
Address______________________________________________
City________________________ST_________ZIP____________
Home Daytime
Phone( )______________ Phone ( )_______________
Personal checks will be held 15 business
days to clear. Money order is preferred.
Call for freight charges on motor freight
shipments (engines, fenders, quarter
panels & skins, hoods, roofs, tailgates)
and other parts noted TRUCK FREIGHT
in catalog.
SUB TOTAL
SALES TAX
NC Residents 7.75%
TOTAL
PLEASE CALL
FOR SHIPPING
COSTS!
Card Owners Signature - Must Be Signed!
IMPORTANT - Copy Account Number From Your Charge Card!
Check or
Money
Order
Enclosed
Exp.
Date
Bank
Name
PAYMENT METHOD
x
(Minimum $6.50
shipping charge.)
ORDER FORM - CATALOG #X1/2015-1
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