THE PERFORMABUILT LAYAWAY STARTER

YOU MUST complete all fields.

If you do not know and answer to something please put N/A in the block.

When you've completed the entire form, hit submit and you will be taken to the deposit page.

The intial deposit amount is $300 US dollars. This amount is not refundable.

After that you can make a $150 US payment at any time as often as you wish and there is no time limit or layaway fee.

Please complete the form below to get started
First Name	* Required.
Last Name	* Required.

Your Email	* Required.
Daytime Phone	* Required.
Evening Phone	* Required.
Other Phone

Street Address	* Required.
City	* Required.
State	* Required.
Postal Code	* Required.

Transmission Type	* Required.
Converter Type	* Required.
To review our available transmission lines, SEE PERFORMANCE TRANSMISSIONS
Vehicle Year	* Required.
Vehicle Make	* Required.
Model	* Required.
Engine Type	* Required.
Additional Information

Thank you for choosing PerformaBuilt! Please take a moment to look over the information above to confirm. Please be sure to include any special instructions in the additional information box provided. There is no such thing as too much information. When your ready, simply hit the SUBMIT button. Provided you have filled out all the required information you will be taken to a secure order page for payment. Our order page is hosted by Yahoo Business on a Yahoo Secure Server for your security. Here you can make payment with you credit or debit card. Please be careful to note the amounts and items. You will be required to enter the amount of the deposit (minimum $300 US). After submitting the payment form, you will recveive confirmation by email to the address you provided. Should you have any questions about our layaway program, or about making the payment, please do not hesitate to contact us at any time. 570-578-5686 or info@performabuilt.com or

info@performatransmission.com

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