Re-Entry Form

Name *

Submitted by:

First Name

Last Name

Email *

Phone *

(###)

###

####

Car Number *

Return To Competiton Per: *

Restart After Retirement (at an MTC)

Permitted Non-Scored Re-Join

Tracker Modules Installed *

Yes

No

N/A

Boost Monitor Installed *

Yes

No

N/A

Boost Sensor Installed *

Yes

No

N/A

Once this form is submitted, you must arrange for a technical inspection sign off before you will be allowed to restart. *

snodrifttech@gmail.com 260-579-3959

OK

Thank you! Your form will be reviewed by the Clerk of the Course.