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Get Fuel Order Form

Important Please Read Please print and use this form to pre-order your racing fuel for each event. Please check the appropriate event below and use only one form per event. Orders must be placed and prepaid 10 days in advance of the race date. All fuel orders must be received by the appropriate VP Racing Fuels office by the order cut-off date. 368. 1869 May 21 New England Forest Jul. 13-14 Newry ME Jul. 2 Olympus Rally Sep. 22-23 Ocean Shores WA Sep. 4 Credit Card Authorization Fuel Order Fuel Price/ Gallon Rally Max 12. 00 MS109e VP100 54g 30g 15g 5g Card Name Address City State Zip Phone Number Card Number Price does not include drum deposit or pail cost. Order Form Security Code By signing below I hereby authorize VP Racing Fuels Inc. to apply charges to my credit card for the order I have placed. Race Team Name Contact Exp. Date Signature Alt. Please check the appropriate event below and use only one form per event. Orders must be placed and prepaid 10 days in advance of the race date. All fuel orders must be received by the appropriate VP Racing Fuels office by the order cut-off date. VP will not guarantee the delivery of any order received after the order cut-off date. There will not be extra fuel available at the event so please make sure to order all the fuel that you need for the race. No refunds once your orders have been placed* Race Race Date Location VP Office VP Phone VP Fax Order Cut-off Sno Drift Rally Jan* 27-28 Atlanta MI VP Midwest 812. 466. 1175 Jan* 16 Rally in 100 Acre Wood Feb. 24-25 Salem MO Feb. 13 Oregon Trail Rally May 4-6 Portland OR VP West 951. 696. 5100 951. 696. 5577 Apr* 16 Susquehannock Trail Rally Jun* 1-2 Wellsboro PA VP East 302. 368. 1500 302. 368. 1869 May 21 New England Forest Jul* 13-14 Newry ME Jul* 2 Olympus Rally Sep* 22-23 Ocean Shores WA Sep* 4 Credit Card Authorization Fuel Order Fuel Price/ Gallon Rally Max 12. 00 MS109e VP100 54g 30g 15g 5g Card Name Address City State Zip Phone Number Card Number Price does not include drum deposit or pail cost. Order Form Security Code By signing below I hereby authorize VP Racing Fuels Inc* to apply charges to my credit card for the order I have placed* Race Team Name Contact Exp* Date Signature Alt. Phone email Please fill out the order form completely. Missing or incomplete information may delay your order. Please make sure to sign the credit card authorization to complete your credit card transaction* Fax the completed order form to the office designated for the race event. All fuel orders must be received by the appropriate VP Racing Fuels office by the order cut-off date. VP will not guarantee the delivery of any order received after the order cut-off date. There will not be extra fuel available at the event so please make sure to order all the fuel that you need for the race. VP will not guarantee the delivery of any order received after the order cut-off date. There will not be extra fuel available at the event so please make sure to order all the fuel that you need for the race. No refunds once your orders have been placed* Race Race Date Location VP Office VP Phone VP Fax Order Cut-off Sno Drift Rally Jan* 27-28 Atlanta MI VP Midwest 812.

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