Name: Email:
Company: Phone #:
Your Website:
Address:City:State:Zip:
You must have a UPS account. To obtain a UPS Account go to UPS.COM. Takes like 5 minutes. UPS Account #:
Type your sample request in the box below. Please be specific using our part number. We will not except a random request. No Charge for the sample. Customer pays the shipping. Limit the request to 1 or 2 items. Make sure your UPS Account is valid or the request will be rejected ..You can type as much as you need in the box below:Sample Request :
If your request is of a personel nature, it will not be filled. This is for business requests only. If the form is not completely filled in the request will be rejected.