Fillable Official Vscca Log Book Request Form printable pdf download

Official VSCCA Log Book Request Form

• Fill in all relevant information in the spaces provided and present the

form (which will serve as the vehicle’s logbook for its first event only) to

the Tech Inspector, who will make note of any necessary changes and

indicate approval.

• Present the form to a member of the Car Classification Committee

(current members include Jerry Greaves, Cap Chenoweth, Benjamin Leroy

Bragg IV, Keith Goring and Glenn Reynolds) who will make note of any

necessary changes and indicate approval.

• Send the completed form, along with two photographs (¾ front view and

¾ rear view) depicting the vehicle in its entirety with your permanent

VSCCA number and a check payable to VSCCA, Inc. in the amount of

$25.00) to: George Vapaa - 36 S. Cliffe Dr., Wilmington, DE 19809

Name _______________________________________ VSCCA Permanent Number ____________

Address _________________________________________________________________________

City ____________________________ State ______ Zip Code __________ Country ___________

Telephone Number ____________________ e-mail Address _______________________________

Manufacturer/Model _______________________________________________________________

Manufacturer Serial Number ______________________________ Year of Manufacture _________

Type (roadster, formula, sports racing, GT, etc.) _________________________________________

Body Material(s) ____________________________ Color(s) ______________________________

Engine Manufacturer _______________________ Engine Serial Number ____________________

Bore___________ Stroke ___________ Cylinders ______ Displacement _____________________

Engine Induction (Type, Size, Make, Number) __________________________________________

Transmission (Manufacturer and Type) ___________________________Wheelbase ____________

Wheel Diameter: Front _____ Rear ______ Wheel Rim Width: Front_______ Rear ________

Tire Size (e.g., 550L15): Front ______________ Rear _______________

Actual Tire (tread) Width: Front ______________ Rear _______________

Tire(overall) Diameter: Front ______________ Rear _______________

Track : Front ______________ Rear _______________

Brake type (Disc/Drum): Front ______________ Rear _______________

For Tech Inspector / CCC Use Only: Any necessary changes _____________________________

________________________________________________________________________________

Tech Inspection ______________________________________________ Date ________________

Car Classification _____________________________________________ Date _______________

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Official Vscca Log Book Request Form