Instructions:

Print this web page, fill it in and send it along with a cheque or money order to:

Vorsicht Canada
PO Box #115 105-10277 135^th ST
Surrey BC,  Canada   V3T 4C3

Name:__________________________________

Address:________________________________            Phone:_______________________

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Car:

Make:  ____ Audi     ____Volkswagen

Year:_______       Model:__________________________

Car Modifications (If Any):

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Pre Registration Fee - $10.00
                                    Pre-registration fee must be received by July 30, 2000.
                                    After July 30, 2000 registration fee is $12.00.

For office use only:

____ Stock     ____ Mod 1     ____ Mod 2     ____ Pro Tuner