Superchips Contingency Registration


Contingency Registration

Welcome to Superchips Contingency Registration.
Ü For questions about registration, please contact:

Please complete the form below to register.

Jim McGinn

jim@rmiatlanta.com

RMI Atlanta
2498 Jett Ferry Road
Suite 100

Atlanta, GA 30338
770.399.9668 - phone

770.391.9518 - fax

Required Fields: All required fields are marked with (*)

About Me

J My Name

Salutation First Name* M.I. Last Name* (Jr. Sr. etc)

8 My Email Address*



+ My Mailing Address

Street Address*

(Suite, etc.)

c/o etc.

City *

State*

Zip/Postal Code*

Country*

) Other Contact Information

Phone* Ext

Toll FREE Ext

Mobile Phone

FAX

My Tuner(s)

Type/Model Serial Number*

*

Purchase Information

z Where did you purchase your Superchips tuner(s)?

Place of Purchase*

Address

City

State

Zip/Postal Code

Country

ª
Internet Purchase

Check this box if you purchased any of your tuner(s) on the Internet
Purchase Web-Site: (Example: http://www.superchips.com)

Sanctioning Body *



Be sure all of the required* fields are completed and click 'Complete My Registration' below.

Welcome to Superchips Contingency Registration.	Ü For questions about registration, please contact:
Please complete the form below to register.		Jim McGinn jim@rmiatlanta.com RMI Atlanta 2498 Jett Ferry Road Suite 100 Atlanta, GA 30338 770.399.9668 - phone 770.391.9518 - fax

J My Name
Salutation	First Name*	M.I.	Last Name*	(Jr. Sr. etc)

+ My Mailing Address
Street Address*
(Suite, etc.)
c/o etc.
City *
State*
Zip/Postal Code*
Country*

) Other Contact Information
Phone*	Ext
Toll FREE	Ext
Mobile Phone
FAX

z Where did you purchase your Superchips tuner(s)?
Place of Purchase*
Address
City
State
Zip/Postal Code
Country

ª Internet Purchase	Check this box if you purchased any of your tuner(s) on the Internet Purchase Web-Site: (Example: http://www.superchips.com)