Little Indians Survey & Registry of 1961-1963 Tempest/LeMans Survey

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SURVEY/REGISTRY 1961-1963 Tempest/LeMans (Please fill this form out completely, print and mail to the address below)
Owner's Name: POCI Member Little Indians Chapter Member Street: City: State: Zip: Phone with Area Code: E-Mail: HOW DID YOU HEAR OF OUR CLUB?
Vehicle 1: YEAR (pick one): 1961 1962 1963 TEMPEST LeMANS MODEL: SAFARI WAGON 4-DR 2-DR CONVERTIBLE RACER ENGINE: 4-CYL V-8, cu. in ORIGINAL MODIFIED CARB: 1-BBL 2-BBL 4-BBL TRANSMISSION: AUTO 3-SPEED 4-SPEED TRANSAXLE MODIFIED CONDITION (choose all that apply) PARTS CAR DRIVER RACER RESTORATION/PROJECT SHOW COLOR/PAINT EXT. COLOR/PAINT INT. TOP/ 2nd COLOR (opt) ORIGINAL COLORS? FIREWALL TRIM PLATE CODES DOOR FRAME VIN ENGINE BLOCK CODE OPTIONS (check all that apply) RADIO A/C BUCKET SEATS TACH CLOCK P/S P/B TINTED GLASS POWER TOP (conv.)	Vehicle 2: YEAR (pick one): 1961 1962 1963 TEMPEST LeMANS MODEL: SAFARI WAGON 4-DR 2-DR CONVERTIBLE RACER ENGINE: 4-CYL V-8, cu. in ORIGINAL MODIFIED CARB: 1-BBL 2-BBL 4-BBL TRANSMISSION: AUTO 3-SPEED 4-SPEED TRANSAXLE MODIFIED CONDITION (choose all that apply) PARTS CAR DRIVER RACER RESTORATION/PROJECT SHOW COLOR/PAINT EXT. COLOR/PAINT INT. TOP/2nd COLOR (opt) ORIGINAL COLORS? FIREWALL TRIM PLATE CODES DOOR FRAME VIN ENGINE BLOCK CODE OPTIONS (check all that apply) RADIO A/C BUCKET SEATS TACH CLOCK P/S P/B TINTED GLASS POWER TOP (conv.)
SEND TO: LITTLE INDIANS CHAPTER OF POCI, c/o GREG WALTERS, PRESIDENT, 1706 Winding Ridge Trail, Knoxville, TN 37922

Contact Greg Walters, LIC President and Registry Coordinator for additional information. The Little Indians Chapter sponsors events, tours, family get-togethers, car shows, etc. Suggestions from members are always welcome and member participation is the strength of the Club.