Wiring Request Form

Please fill out the form completely. With complete information, we're better able to meet your custom automotive wiring and component needs.

Customer Information:
First Name: Last Name: Company:
Email Address: Phone: FAX:
Street Address:
Street Address:
City: State: Zip:
   

Wiring Board Specifications:
Describe your project in as much detail as possible:
Vehicle: Year:   Make:   Body Style:
Engine: Year:   Make:   Cubic Inches:
Transmission: Year:   Make:   Model:
Distributor:



Aftermarket—Manufacturer Name and Model:
Electronic Control Module:



External Coil:



Aftermarket—Manufacturer Name and Model:
Steering Column:

 Year:   Make:   Model:
 Turn Signals     Ignition in Column     Headlamp Switch
 Wiper Switch     Cruise Control
Alternator:

   


Single Wire Type
Electric Gauges:


Voltmeter
Ammeter
Charge Light Indicator
Starter:



Note:
 Fuses may be substituted with circuit breakers at additional cost. The “Black Box” wiring board comes complete with panel, fuses, terminal connectors, cover, mounting plate, Torx wrench, hardware, horn relay, turn signal flasher, hazard flasher, ignition resistor and installation diagrams and instructions
Also Available:
Complete labeled wire sets, switches, plugs, labeled shrink tubing, etc.
Additional Information
and Comments:

 

Electronic Mail:  CONSULT @ SILVASWIREANDRODS . COM

If you prefer, please call us at 805-461-5120, or download, print and mail the Wiring Request Form (.pdf format) to Silva's Wire and Rods, 3250 El Camino Real, Unit F1, Atascadero, CA 93422.


Silva's Wire and Rods,   PRIVACY POLICY — We never share or sell Customer Information with anyone. Period.