Requesting A Sample - submission form

"Our bookmarks are awesome. We are very pleased. I hope to do more business with you after our new fiscal year. Thanks for all your help and hard work."

Sheryl Stephens, Alumni Foundation
Delta State University

If you've narrowed your selection down and would like to see a sample of a product before making a final decision, we'd be happy to send you one!

*Use the "tab" key to move from blank to blank. If you hit the "enter" key, it will submit the form at that stage and you'll need to hit "back" on your browser to complete and resubmit the form.

SAMPLE REQUEST FORM

Request number (please enter date)

(## ## ##) month date year - two digits with no / or - in between

What program/event is this for?

When is the program/event?

(enter "no specific date" if this is for an ongoing program or you are doing advance research for an event several months away)

*How did you see, hear or find out about us?

(please list name (     ) of specific conference, magazine, website, etc)

postcard mailing (    ) conference (    ) online newsletter

other - how? (    ) magazine (    ) internet search

(    ) website (    ) salesperson called

(    ) listserv (    ) referred me

First Item #

Description

Desired Item Color

(we always try to send a sample in your desired color if one is available. If not, another color will be substituted)

Desired Imprint Color

(we always try to send a sample with your desired imprint color if one is available. If not, another color will be substituted)

Item Size (if applicable)

What quantity might you need to order?

Second Item #

Description

Desired Item Color

Desired Imprint Color

Item Size (if applicable)

What quantity might you need to order?

SHIP TO ADDRESS:

Name

Title/Department

Organization/School

Street Address
(CANNOT SHIP TO A PO BOX!)

Address 2

City, State, ZIP

Phone # and ext. #

Fax #

*E-mail

Fedex or UPS shipper #

(must provide if item is over $10.00 or requires either international or express shipping)

Additional Comments

Thank you for your request.
We hope we can help make your program or event a success!

*Please print this form and read below if you are not using Internet Explorer as your web browser!

When hitting submit below, some customers using the Mozilla Firefox and MacSafari browsers have gotten a pop up email box instead of a confirmation of submission page. If this happens, we will not receive your submission. Please simply print and fax the form to us at (678) 482-0771 instead so that we can respond immediately to your request. Thank you and we hope we can work with you soon!

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Product selection and pricing are subject to change without notice. All pricing in U.S. $.