Sample Request Form

Samples will be sent upon request at regular price, plus 100% sample charge, plus shipping and handling costs.  Shipping costs to be determined at time of shipment.  Samples are for wholesale purposes only and not for retail consumer purchase.  Particular colors and sizes cannot be guaranteed.  Samples are not returnable.  If you purchase from a sample shipped within 30 days, provide us at the time of ordering, with the sample invoice number, and we will give you an allowance for the previous sample charge.  Payment is by Discover, Mastercard or Visa.
 
Customer Info 
Buyer's Name 
*
Business Name 
*
Customer # (if applicable) 
Invoicing Address 
*
City 
*
State 
*
Zip 
*
Telephone # 
*
Fax # 
Email Address 
*
 
Shipping Info 
Customer Shipping Name 
*
Shipping Address 
*
City 
*
State 
*
Zip 
*
Country 
*
 
Order Info 
Quantity (pieces) 
*
Style # 
*
Product Description 
Indicate your consent to the selling Terms and Conditions

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