F2B1

VHEligibilityForm

VINTAGE HISTORIC RACE CAR ELIGIBILITY FORM

Original DATE form filled in:*
CAR YEAR:*
MAKE OF CAR:*
MODEL:*
Race Car Number (office use only)
BODY STYLE:* Coupe Convertible Formula Car Sports Racer
CHASSIS/SERIAL #:*
COLOUR(S):*
This car has raced with VARAC
When & by whom has this car raced with VARAC:
This Car has a Log Book
Log Book Number & Organization:
Date Issued of Log Book:
List the most significant racing history of this car:
My car is registering for:
Type of car:* Production Sedan Formula Car Sports Racer Production Sports Car
List any unusual specifications or modifcations that may affect classification or acceptance. Sportsracers, specify preparation rules that apply:
This car is substantially compliant with VARAC's Rules & Regulations YES NO
ENGINE:

Engine Manufacturer (OEM):*
Current Engine, Model, Type:
Date of Manufacture of engine:
Stock Displacement:
Current Displacement:
BORE ORIGINAL CURRENT
STROKE ORIGINAL CURRENT
No.of Cylinders:
Head Material:
Block Material:
Overhead Cam:
Roller Rockers:
Dry Sump:
Induction:

Induction -- Original OEM: YES NO
Induction TYPE: CARB FUEL INJECTION MFG.(OEM)
Total # of Venturis (throats):
TURBO
SUPER CHARGED
Comments on Induction:
Electrical Charging System:

Generator
Alternator
None
Ignition:

Magneto
Points
Electronic
MSD
Ignition - Other
Transmission:

Period / Standard
# of Forward Speeds
Current Transmission
Transmission Comments:
Steering Gear in Period: YES NO
Differential:
Confirm LSD in Period:
Brakes

Brakes are Period Correct
Driver Remote Adjustable yes no
List Front & Rear drum/disc/size and Comments:
Wheels & Tires

Wheel Diameter - Front & Rear: (list original and current if it has changed)
Tire Make/Model & Tire Size (front & rear): (List original and current if it has changed)
TIRE INFORMATION: TREADED SLICKS GROOVED SLICKS BIAS RADIAL
Track (measured Center to Center)

Track at Manufacture (front & rear):
Track - Current (front & rear):
Suspension Design & Geometry

Period Correct yes no
Modifications of Suspension:
Shocks

Shocks are Period Correct
Shocks - List Front / Rear, Comments
CHASSIS:

Weight of Car: (pounds)
CHASSIS - Period Correct yes no
Modifications to Chassis:
Body Work

Period Correct - Style / Material:
Current Style / Material:
List Modifications for bodywork:
Windshield / Windscreen: yes no
Headlights: yes no
Safety Equipment

Fuel Cell:
Fire Extinguisher System:
Rain Light:
Safety Harness Type:
Roll Bar or Cage:
Confirmation:

This car is substantially compliant with VARAC's Rules & Regulations: YES NO
I have read and am familiar with the current VARAC General Rules and Regulations:* YES NO
DATE INFO ON FORM CONFIRMED

*

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