2012 RACE WEEK
February 3-11, 2012

 LOCAL CAR REQUEST FORM
                   
NAME:  ____________________________________________
ADDRESS:  ____________________________________________

                       ____________________________________________
PHONE:  ____________________________________________
EMAIL:  ____________________________________________
CAR #:  ____________________________________________

 CAR

 DEMENSIONS:          WIDTH                                 FEET
                                       LENGTH                               FEET


 NAME OF TRACK WHERE YOU RACE:  ____________________________________________
 

Please make sure that all of the requested information is completed.
Please submit your information by Monday, January 23, 2012 to:

Chambersburg Mall

Attn: Dore Diehl
864 Chambersburg Mall
Chambersburg, PA 17202

or deliver to the Mall Management Office.

Autograph Night – Saturday, February 11, 2012 – 6:00-8:00 p.m.

Autograph Cards – Brian Prye will be here the night of set-up (Thursday, Feb, 2, 2012) and will be available to take
orders for autograph cards.  You may order them from Brian or you may supply your own.  For more information,
please contact Roger Gettel at 717.532.8581.