Big Al's List Feature Car Questionnaire and Release Form
Big Al's List / 488 Monroe Blvd. / Painesville, Ohio 44077
www.BigAlsList.com
Name              
Address              
City, State & Zip              
Phone     Email        
Clubs & Organizations            
Spouse's Name              
Occupation              
Please Sign Here         Date    
Car Information
Year      
Make              
Model              
Color              
Builder              
Value              
Engine
Year   Make   Cylinders   Horse Power  
Cubic Inch   Bore & Stroke      
Carburetor       Injection      
Blower       Turbo-Charger      
Intake      
Heads       Valves      
Cam   Lifters   Push Rods      
Rockers   Springs      
Pistons       Rods      
Crankshaft        
Oil Pan       Sump Pump      
Water Pump       Belt Drive      
Ignition        
Builder        
Exhaust   Stock   Headers      
Radiator   Copper/Brass   Aluminum      
Air Cleaner    
Valve Covers    
Drive Train
Automatic Trans   Brand   Speed   Over Drive  
Converter     Shifter   Trans Cooler  
Manual Trans   Brand   Speed   Over Drive  
Clutch     Shifter      
Drive Shaft      
Drive Shaft Loop      
Rear End       Ratio      
Wheels - Front       Tires      
Wheels - Rear       Tires      
Body
Custom Body            
Steel / Glass              
Paint              
Painter              
Bumper - Front              
Bumper - Rear              
Grill              
Custom Work             use back
2, 3 or 4 Door  
3, 4 or 5 Window   Tinted Glass      
Interior
Seats              
Material       Color      
Upholster              
Instruments Stock     Digital      
Steering Wheel              
Sound System              
Air Conditioning      
Power Windows   Power Seats   Power Doors      
Wiring              
Chassis
Front End              
Brakes              
Steering              
Shocks              
Suspension              
Interesting Facts
How long have you owned it?      
How long have you worked on it?            
Who helped you?            
Where did you find it?            
Who owned it before you?            
What are your plans with it?            
Do you own other Neat Rods?.            
Trophies and Accolades            
Photographer            
Photographer Release Signature            
 
 
Interesting History of Your Vehicle
This is the part that makes your story interesting! Do you have any funny or not so funny events that happened
to you or your car? Have you always wanted a car like this or is this just a ride on the path to a car you
have always dreamed of? The more information you can put here, the better the story will read to others!