Electrimotion Order Form
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| Company Name* | |
| Company Phone Number | |
| Contact Name | |
| Contact Email Address | |
| Shipping Address | |
| Shipping City, State, Zip | |
| Billing Address | |
| Billing City, State, Zip | |
Order Common Items Below by checking the boxes.A description of the section goes here. |
| Safety Box $425 | Top Fuel Dragster Top Fuel Funny Car Top Alcohol Dragster A-Fuel Dragster Alcohol Funny car Includes Safety Box, 2 Air valves, Tether cord,
Manifold Tether and hardware |
Replacement Tether Kits $65 ea
Enter Qty in Note
Field | TopFuel Alky Includes 1 Tether, 6" for Topfuel or 32" for
Alcohol, 1 manifold Anchor, and Tether Dog Bones |
Air Cylinders $33 ea
Enter Qty required | *Not Included in the Safety Box Kit. |
| RF Shutdown Kit $250 | TopFuel Alky Includes RF Shutdown Receiver and 14.5ft Cable |
| Crank Triggers $140 | 90 Deg, 18", Amp Connector (Standard for Blown Alcohol) Other, Please specify in note field below |
| Other Notes | |
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