Questionnaire


Your Name:

Address:

City: State or Province:

Country: Zip or Postal Code:

E:mail Address:
(I need this to send you more information!)

Homepage URL:

Telephone number?


Do you own a Galaxie?
YES NO No but, I'm looking for one, described below

If you do, what year(s)?
1959 1960 1961 1962 1963 1963 1964 1965 1966 1967
1968 1969 1970 1971 1972 1973 1974

What body style(s)?
fastback 2 door hardtop 4 door hardtop 2 door sedan 4 door sedan
retractable hardtop convertible station wagon

What Model(s)?
Galaxie/Fairlane Starliner Sunliner Custom Galaxie 500 Galaxie 500/XL
7 Litre XL LTD Country Sedan Country Squire Ranch Wagon

What size engine(s)?
223 6cyl 260 V8 300 6cyl 289 V8 302 V8 292 V8 312 V8
332 V8 351 Winsor 351 Cleveland 352 V8 390 V8 400 V8
406 V8 427 V8 428 V8 429 V8 460 V8

Please leave any comments you may have...


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