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R&V Engine Register Form

Please complete this form.
Click on Submit at the end of the form when ready to send.
Do NOT hit "Enter" on your keyboard while completing the form
or it will be sent before you have completed it.

Please give me as much information as possible, important fields are
Name
Address
Phone number
E mail address
Serial number
Horsepower

Serial Number:
Year Engine Built :
Engine Horse Power:
Speed:

What type of Engine? Vertical Horizontal (click in relevant box)

Ignition Type:
Magneto type:
Magneto serial number:
Engine Measurements
Big end diameter:
Main bearing diameter:
Flywheel diameter:
Flywheel width:
Cylinder bore diameter:
Piston stroke:
Number of rings:
Gudgeon / Wrist pin diameter:
Inlet valve diameter:
Inlet valve stem length:
Exhaust valve diameter:
Exhaust valve stem length:
Muffler:
Governor Type: Flyball / flywheel
Carburetor:

Type of Head on engine	Water Cooled or Dry/air cooled
Type of Pushrod	Round or Flat click relevant circles
Bolt on Barrel	Yes or No
Lubrication

Cooling System Type

Engine Condition

GENERAL INFORMATION

Engine history-(what was it used for)

Owners name:

Phone number:

E-mail Address:

Date of Birth

The information above is held as confidential, it allows me to contact you and also guage the age of members so I can get a feel for who is collecting and geographical location of engines.

Postal Address

Do you have manuals or brochures?:

Do you give permission for this information to be used by other members of the register?
yes no click in relevant box

Send form back with as much data as possible, keep a copy and fill in the rest if you ever have to do work on engine. If I have forgotten something just add it to the comments section. Spread the word around - Thank you.

Any comments?

After you have filled out the above form hit "Submit" below.
Thank you.

All information supplied here is confidential
between you and the R&V Registrar (Me)

R&V Engine Register Form

Carburetor:

Owners name:

Phone number:

E-mail Address:

Date of Birth

Postal Address

Do you have manuals or brochures?:

Do you give permission for this information to be used by other members of the register?
yes no click in relevant box

Any comments?

All information supplied here is confidential
between you and the R&V Registrar (Me)

R&V Engine Register Form

Carburetor:

Owners name:

Phone number:

E-mail Address:

Date of Birth

Postal Address

Do you have manuals or brochures?:

Do you give permission for this information to be used by other members of the register? yes no click in relevant box

Any comments?

All information supplied here is confidential between you and the R&V Registrar (Me)

Do you give permission for this information to be used by other members of the register?
yes no click in relevant box

All information supplied here is confidential
between you and the R&V Registrar (Me)