Kanter Auto Products
Secure Order Form

How to place an online order:

1. Write down the descriptions and prices of the parts that you want to order.
2. Then go to this order form and fill in all the necessary information.

Rather Fax your order?
3. *Click here for a printer friendly order blank to fax or mail your order.
4. OR Click here to search and order with our new shopping cart.

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Please fill out and submit this order form, or call our sales staff:

Tel: 1-800-526-1096
or 1-973-334-9575
Mon - Fri
8:30 to 8:00 Eastern Time

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Customer Data

Please enter the address where your credit card statement is sent.
Or place in an alternate address registered to your credit card.
We can only ship to these addresses.

 

Your Full Name
e-mail
Street
Apt:
Additional address info
City
State
Zip or Post Code
Country
Phone
FAX

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Vehicle Data:

Make
Year
Model-Body Style
Engine Size
#Cylinders
# Doors

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Brakes

DrumDisk

ManualPower

DelcoBendixOther

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Steering

ManualPower

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Transmission

StandardAutomatic

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Exhaust

SingleDual

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Air Conditioning

ACNo AC

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Carburetor

1 Barrel2 Barrel4 Barrel

HolleyRochesterStrombergCarterOther

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Fuel Pump

Single ActionDouble Action

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Your Order

Quantity	Description	Price Each	Total
		Total for Parts:
Add 15% Shipping & Handling (8.00 min, 60.00 max). Foreign Shipping and outside 48 states see shipping.
		Total for Order:

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I authorize the above amount to be charged to my MC or Visa credit card: Credit Card Number #   valid thru month / year Your Name on your Credit Card :

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Additional Information or Comments about this Order:

 

Before you Submit your order:
You may want to print this page.
Check it and save it for your records.

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Kanter Auto Products warrants that each item we sell is free from defects in workmanship and materials for as long as you own your car.

For more information on our products and services,
please feel free to use our contact form:

Phone us at 1-973-334-9575 or 800-526-1096,
or FAX your request to 1-973-334-5423.