ASSOCIATION PARTS ORDER FORM

MAIL OR FAX TO: NATIONAL NOSTALGIC NOVA; PO BOX 2344; YORK, PA 17405; FAX (717) 252-1666

OR CALL IT INTO US AT (717)252-4192 OR (717)252-2383

NAME
  
 DATE  
   IF ORDERING PARTS, COMPLETE THE INFORMATION BELOW ABOUT YOUR NOVA TO ASSIST IN PARTS INDENTIFICATION.
 YEAR OF NOVA  
 MODEL  
 # DOORS  
 TRANS  
 INTEROIR COLOR  
 EXTERIOR COLOR  
 ADDRESS  
 CITY  

STATE
  
 ZIP
 PHONE  
 VISA, MC, DISCOVER, AMEX  
 EXP. DATE  
 SIGNATURE  

QUANITY

 PART

NUMBER

 

LB.

 

OZ.

 DECRIPTION OF ITEM
 F B DOLLARS

CENTS
                 
                 
                 
                 
                 
                 
                 
                 
                 

 TOTAL WEIGHT

    

  SUBTOTAL

    

 CONTINENTAL U.S.A.

SHIPPING VIA UPS

0 oz - 1 lb - $6.00

Add $0.60 for each additional lb or fraction

(Canada or Overseas contact National Office)

SHIPPING

    

 PA RESIDENTS ADD 6% SALES TAX

    

TOTAL ENCLOSED

    

 

MAKE CHECKS OR MONEY ORDERS PAYABLE TO NNN

U.S. FUNDS ONLY

ALL BACK ORDERS WILL BE SHIPPED AS SOON AS STOCK IS RECEIVED

 

HOME / ASSOCIATION PARTS