Wheel Inserts Order Form:
Print this form. Fill it out and include it with your order.

Your Name______________________________________

Your Address:____________________________________

_______________________________________________

_______________________________________________

Your Email:______________________________________
(For order status. We will ship to above address.)

Do you want us to Email you when we send out your order ? (yes/no)_________

What year is your Mustang_________________.

What kind of rims does your Mustang have ?: (circle one below)

16" GT rims...........15" Base rims.............17" Optional rims

Which COLOR do you want (circle one): ...Black.....White.....Red.....Yelow.....Blue.....Mustard

TOTAL Order Quantity________________ kits.

PRICE: Wheel insert kit $10.

Mustangworld Club Member Cost $8 per kit.
MWCLUB Number________________________.

TOTAL ORDER AMOUNT (US$)_________________.
(If sending a check, Make checks payable to Mustangworld.com)

Shipping and handling is included.

CA residents add %7.75 SALES TAX to your order.

Mustangworld.com, 2134 Newport Blvd., Costa Mesa, CA 92627.

(MWinsert order form part no. 020999rev3.)