Project Request Form

Restoration Project Request Form
Step 1: FIRST - Complete the form below.
Representative You Spoke With Before Sending Part(s) *

David Mike Curtis James Zack Haven't spoken to anyone yet
Your Name *

First Name Last Name
Company Name
Company Website
Your E-mail Address *
Phone Number *

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State

Zip Code Country
Previous Customer? *

Yes No
How did you hear about us? *

Word of Mouth Amazon.com AlienEnclosures.com Car Show Car Club ClassicAutoAir.com Catalog CJ Pony eBay.com Facebook.com Forums Friend Google.com GraveYardCarz Instagram.com Magazine National Parts Depot Pinterest.com Yahoo.com YouTube.com
Car Club or Car Show Name
Catalog Name
Forum Website/Friend Name/Referrer
Car Information *

Year Make Model Engine & Trim
Who will be doing final installation? *

Myself Mechanic
Parts Requesting to be Restored *

Compressor Condenser Control Drier/Accumulator Hoses POA Valve Expansion Valve Suction Valve Evaporator Switch Unknown
Refrigerant *
Special Notes - What else do we need to know about your project?
Judging Car? Car Show Deadlines, Preferred Complete Dates, etc
Level of Authenticity Desired *

1. I want my a/c to look as close to original as possible for show. 2. I want my a/c to be ready for show, but I don't care about originality. 3. I want my a/c fixed as inexpensively and quickly as possible. 4. Survivor car - make it functional but keep original patina
Enter the message as it's shown *
Send A Picture (Optional)
Final Instructions:

Step 2. Once you click the "Submit" button, you will receive an email with a copy of this completed form.

Step 3. We are monitering this list DAILY and will follow up with you directly when we have a spot open in our production schedule for your project.

Step 4. Once we reach out to you and confirm the scope of the project, we will send you a list of next steps and mailing instructions to ensure your parts arrive safely and intact.
Should be Empty:

Restoration Project Request Form