1965 Shelby Registration Form

Please note:
This form will not give you information about a particular car.
It is for owners to report ownership and other changes. 

NAME:
ADDRESS:
CITY: STATE: ZIP:
PHONE:
E-MAIL:

Please note: Addresses and phone numbers are for internal club use only. Only names, cities, and states (or countries) appear in the Registry. If you would like your name withheld from the next edition of the Registry then please check this box.

SHELBY SERIAL#:     SFM5S (or R)
FORD VIN:            
Note: All Ford VINs are kept confidential.

ORIGINAL DEALER (if known):

MODEL (as designated by the factory):   Street    Comp    Drag

PRESENT FEATURES
(as car is today)
ORIGINAL FEATURES
(as car left factory)
15" steel wheels
15" Shelby/Cragar wheels
15" x 7" American
all fiberglass, round mesh opening
all fiberglass, full opening
fiberglass, steel frame
front-mounted battery
rear-mounted battery
16" dia. steering wheel
15" dia. steering wheel, slotted spokes
15" dia. steering wheel, holes in spokes
factory installed LeMans stripes
dealer installed LeMans stripes
owner installed LeMans stripes
no LeMans stripes
no radio (radio delete plate)
dealer installed radio
owner installed radio


PRESENT COLOR:

PRESENT CONDITION: 5. undergoing restoration
1. original/unrestored 6. wrecked
2. original/restored 7. destroyed
3. modified/unrestored 7. parted-out
4. modified/restored 9. rebodied


THIS IS NEW INFORMATION TO SAAC (as far as I know)
THIS IS A CORRECTION TO THE LATEST REGISTRY
THIS IS AN ADDITION TO THE LATEST REGISTRY
I DON'T KNOW IF MY CAR HAS BEEN IN A PAST REGISTRY


PAST OWNERS: Please list past owners from first to present in
chronological order (use question marks to indicate unknown owners).


INDIVIDUAL HISTORY: List, in chronological order, anything
unique to this car or its owners.


     

Your information will be emailed to the registrar.

1965 SHELBY REGISTRAR:
HOWARD PARDEE
4 BETTY ST
WATERFORD, CT 06385
EMAIL
saachp@snet.net