1970-1972 Chevrolet LS5 Registry - Certificate of Registration/
Stickers/Coins/Etc.

 © LS5 Showcase
Credit Cards accepted are Visa, Mastercard, American Express, and Discover.

** LS5 Certificate of Registration Order Form **

Orders for certificates for Chevelles NOT registered in the LS5 Registry will not be honored and your order will not be processed.

There are no refunds.

Note: The information entered is not checked for validity - please make sure card number/cvv is entered correctly.

Enter quantity for each item - leave blank if not ordering that item.

Your email address for receipt confirmation (Required)
(youremail@yourhost.com)

Your order will NOT be processed without a valid email address.
   
Select your Certificate
type and mailing option (Enter Quantity)
Yes, International Postage is expensive.
A Custom Certificate includes a photo
of your LS5, a Stanard Certificate
does not include a photo of your LS5.

     Standard Certificate - U.S. Mailing Address ↓- $28.95

     Standard Certificate - Outside U.S. Mailing Address ↓- $43.95

     Custom Certificate - U.S. Mailing Address ↓- $33.95

     Custom Certificate - Outside U.S. Mailing Address ↓- $48.95

   
   
Frame Color
 Gold
 Blue
 Green
 Maroon
 Red

   
Ship via USPS Priority Mail? (1 = yes, blank = no)
Leave blank for International Order
  Add USPS Priority Mail? (1 = yes, blank = no) $9.00
Add $4.00 USPS with tracking number?
(1 = yes, blank = no)
Leave blank for International Order
  Add USPS Mail with tracking number? (1 = yes, blank = no) $4.00
VIN of the LS5 Chevrolet for confirmation
   
Name(s) to appear on certificate
(Exact spelling and capitalization)
Leave blank if you do not want a name
   
Ship to Address (1)
   
Ship to Address (2) (if needed)
   
Ship to City
   
Ship to State/Province
   
Ship to ZIP/Postal code
(xxxxx), (xxxxx-xxxx), (xxx xxx)
   
Phone Number (often required for shipping labels) (xxx)-(xxx)-(xxxx)
   
  Check out the SS454 Coins, Hat/Lapel Pin, and stickers ↓
  Prices for U.S. Mailing Address ONLY ↓
   
© LS5 REGISTRY - All Rights Reserved Add Hat/Shirt Button?

  Enter Quantity $6.00 ea.

While supplies last
   
© LS5 REGISTRY - All Rights Reserved
Collector Coin #1
© LS5 REGISTRY - All Rights Reserved
Protective Case for Coin
Add 2-inch Chevelle SS454 Collector Coin?

  Coin Only - Enter Quantity $22.00 ea.
  Coin w/protective case - Enter Quantity $23.50 ea.

  Coin w/black velvet box - Enter Quantity $29.00 ea.
  Coin w/blue velvet box - Enter Quantity $29.00 ea.
  Coin w/red velvet box - Enter Quantity $29.00 ea.
© LS5 REGISTRY - All Rights Reserved Sample Red Velvet Display Box - Blue and Black also available

Velvet Display Box colors are in limited supply...
   
© LS5 REGISTRY - All Rights Reserved Add 1.5-inch Chevelle/Corvette SS454 Collector Chip?

  Enter Quantity $5.00 ea. with Certificate only
   
© LS5 REGISTRY - All Rights Reserved Add a sheet of LS5 Registrant toolbox/showcard stickers?

  Enter Quantity $12.50 sheet of 20 (2-inch)
  Enter Quantity $12.50 sheet of 12 (2.5-inch)
  Enter Quantity $12.50 sheet of 6 (3.5 inch)
   
© LS5 REGISTRY - All Rights Reserved Add a sheet of LS5 Registrant Custom stickers?

  Enter Quantity $12.50 sheet of 20 (2-inch)
  Enter Quantity $12.50 sheet of 12 (2.5-inch)
  Enter Quantity $12.50 sheet of 6 (3.5-inch)
   
© LS5 REGISTRY - All Rights Reserved Add 1-inch hat/lapel pin?

  Enter Quantity $6.00 ea.
   
© LS5 REGISTRY - All Rights Reserved Add a 2-inch static cling sticker?

  Enter Quantity $2.00 ea.
   
© LS5 REGISTRY - All Rights Reserved Add SS454 Keychain ?

  Enter Quantity $8.95 ea.
   
© LS6 REGISTRY - All Rights Reserved Add Shop Manuals DVD ?

  Enter Quantity $34.95 ea. (media version)

(Download version available at ChevelleCD.net)
   
© LS5 REGISTRY - All Rights Reserved Add SS396/SS454 Build Sheet Decoder?

  Enter Quantity $49.95 ea. (media verson)

(Download version available at ChevelleCD.net)
   
© LS5 REGISTRY - All Rights Reserved© LS5 REGISTRY - All Rights Reserved   Enter Quantity One Photo Calendar $8.00 with certificate order only

  Enter Quantity Two Photo Calendar $8.00 with certificate order only
   
 
$  >> Order Total

   

Card Information

 
Card Type (Check One)
 VISA
 MASTERCARD
 AMERICAN EXPRESS
 DISCOVER

   
Name as it appears on card
   
Card Number
(xxxx-xxxx-xxxx-xxxx) or (xxxxxxxxxxxxxxxx)
   
CVV Code on back of card
(xxx)
   
Expiration Date (mm/yy) (xx/xx)
   
Billing ZIP/Postal code of cardholder
(xxxxx), (xxxxx-xxxx), (xxx xxx)
   
If ordering ANY item with no certificate to any mailing address outside the U.S. an additional postage fee will be added to your credit card order. I will confirm mailing costs (generally International First Class) with USPS website and email you the additional postage charge for you to confirm order with additional postage costs. Typically postage via USPS First Class International is a mnimum of $15.00.

If any accessory is mailed along with a Certificate of Registration, the additional weight may have an effect on mailing costs. If significant, all items will be mailed to a U.S mailing address will be mailed via USPS Priority Mail.