Corvette Specialties of MD West restoration order form. Send with parts for service.

FORM INSTRUCTIONS:

Corvette Restoration Services

Sorry, we have discontinued our Restoration services at this time. We apologize for any inconvenience this may cause.

Customer Information
Customer Name*
Email Address*
Primary Phone #*
Alt Phone #
Shipping Information
Return Shipping Address*
Note: Must be a physical address - we cannot ship to PO Boxes.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Vehicle Information
Year, horsepower, judging status, etc.
Year*
Horsepower
Do you plan to have your Corvette judged at NCRS or Bloomington type events?
- Yes
- No
What are you sending?
Items Enclosed*
- Dash Cluster Assembly with gauges (1963-1967 ONLY)
- Tachometer (1953-1977 ONLY)
- Speedometer (1953-1977 ONLY)
- Gauge: Fuel (1953-1967 ONLY)
- Gauge: Temp (1953-1967 ONLY)
- Gauge: Battery (1953-1967 ONLY)
- Gauge: Oil (1953-1967 ONLY)
- Clocks (1963-1982 ONLY)
- Glove Box Door/Assembly (1964-1967 ONLY)
- Other (Specify below)
1958-1962 Owners Please Note: We no longer restore the outer dash housings for 1958-1962 gauge clusters. Gauges should be left in their individual housings/pods only when sending for restoration or repair. Please do not send gauges still in the outer dash housings.
1953-1962 OWNERS PLEASE NOTE: Gauges should be left in their housings/pods when sending for restoration or repair.
Are you sending gauges for repair only with no EXTERNAL cosmetics?*
PLEASE NOTE: Many housings/bezels will require internal repainting due to chipping of old paint that will flake off during reassembly. External appearance will remain the same.
- Full Cosmetics - Interior & exterior
- Repair Only - Perform interior repainting if necessary to prevent flaking
1963-1967 OWNERS NOTE: Please DO NOT send cluster housings that are not being restored. Due to circumstances beyond our control (i.e. chipping paint, etc.), we cannot reassemble gauge clusters without restoring the housings as well. If you absolutely do not want your gauge cluster housing restored, please remove your gauges and send them individually. Thank you.
Other - Please Specify:
Other:
Dash Cluster Assembly
PLEASE NOTE: Leave key in ignition -OR- remove ignition before shipping. Additional charge to remove ignition cylinder if key is not provided.
Odometer Options:*
PLEASE NOTE: Zeroed odometers will still show a few miles due to testing and calibration.
- Set mileage to zero - Requires odometer replacement
- Keep existing mileage - Odometer replacement only if mechanically or cosmetically necessary
63-67 Clusters: Are you including a Headlight Motor Switch?*
- Yes
- No
Speedometer
Odometer Options:*
PLEASE NOTE: Zeroed odometers will still show a few miles due to testing and calibration.
- Set mileage to zero - Requires odometer replacement
- Keep existing mileage - Odometer replacement only if mechanically or cosmetically necessary
Tachometer
Is this Tachometer a 1953-1961 unit?*
- Yes
- No
Please specify drive type:*
- Distributor Drive
- Generator Drive
Clocks
Clock Movement Type*
- Standard Movement - As original but prone to failure. Correct for judging.
- Quartz Movement - More reliable but may lose a point if judged.
Headlight Motor(s)
Headlight Motor Quantity
Please enter a number from 1 to 99.
Wiper Motor
Wiper Motor Restoration Type*
See our Wiper Motor Restoration page for more information about Restoration Levels.
- TYPE I
- TYPE II
- TYPE III
Is your Wiper Motor a 1958-1962 unit?*
- Yes
- No
Are you including a Washer Pump Vacuum Coordinator?*
Used to engage the Windshield Washers, which were optional on 1958-1960 Corvettes and standard on 1961-1962 Corvettes.
- Yes
- No
Does your Washer Pump Vacuum Coordinator need to work?*
We will clean your coordinator at no additional charge, but please specify if coordinator needs to be functional. Additional charges apply as there is a limited supply of NOS coordinators available. (We make this optional since many owners do not drive their Corvette in bad weather)
- Yes ($175 additional for coordinator replacement)
- No
Console
Console Paint Color*
The paint color we will restore on your Console.
Notes
Please list all other comments, instructions, or requests here. Be as specific as possible. For example: red line changes, additional services, etc.
Please list all other comments, instructions, or requests here. Be as specific as possible. For example: red line changes, additional services, etc.
CAPTCHA
Corvette Specialties of MD West will make every effort to notify the customer should unexpected or unusual situations arise causing a substantial overage in your Service Fee. Remember we are working on items that are often 60 or more years old and are meant to be replaced when a failure occurs!
When complete, press 'SUBMIT' below.
You will be prompted to print your forms on the next page.

Corvette Restoration Services

Customer Information

Shipping Information

Vehicle Information

What are you sending?

Other - Please Specify:

Dash Cluster Assembly

Speedometer

Tachometer

Clocks

Headlight Motor(s)

Wiper Motor

Console

Notes

When complete, press 'SUBMIT' below.