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PostPosted: Sat Jun 04, 2016 5:10 am 
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Location: Blacksburg, VA
Car Model*:
SLANT SIX RACING NEWS APPLICATION FOR RECORD

Driver's Name and Address:

Car Owner's Name and Address:

Make, Model, and Year of Vehicle:

Event where runs were made, must include a scheduled Slant Six Points Race:

Date or dates:

Quarter or eighth mile:

Actual Weight including driver:

AA - Under 2,000# any type chassis
A - 2,000-2,349# door cars only
B - 2,350-2,699# door cars only
C - 2,700-3,199# door cars only
D - 3,200# and up door cars only

Type of Block:

Tall 198-225 style
Short 170 style

Fuel and/or Modifications Used:
G - Gasoline only (must be NHRA legal) normally aspirated
A - Alcohol only normally aspirated (including E85)
N - Nitrous with gasoline or alcohol normally aspirated
U - Unlimited including Supercharged or Turbocharged, can also use nitrous and/or nitromethane

Attach copies of the time slips for the record setting run and a back up run within 1% & a copy of the permission letter from the track if you are using nitromethane.

Certification:
I hereby certify that the vehicle described above was awarded these time slips at the event indicated. If my car didn't weigh this much, or used a different type of fuel, I will go back to racing a Ford Falcon with a 144 cubic inch engine.

To be signed and dated by Driver and Car Owner:

Send to:
Seymour Pederson
2513 Princeton Ct.
St. Louis Park, MN 55416

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