Ultraflexx Request Sample Form

Sample Request Form

*EFFECTIVE JANUARY 2008- REQUESTOR WILL BE RESPONSIBLE FOR ALL FREIGHT CHARGES. SAMPLE MATERIALS ARE FREE OF CHARGE.

Please fill in the form below to complete your request
All areas with a * must be filled in.

Product information/swatches:

Please put an X in the appropriate box(es):

	Full PVC Product line (excluding textiles) 4" x 6" swatch book

	Full Textile Product line 4" x 6" swatch book

	Full Product line 10" x 12" Hard Cover Binder with spec sheets & swatches (Binder is subject to a $35 dollar charge)


	Wallscapes 3.5" x 8" swatch book

	BIOflex- (Biodegradable PVC) literature packet with swatch

	Ultra Carpet Extra (UV & solvent)
	Printed hand sample	Unprinted hand sample

Check out our new products!
Normandy Lite (11oz. version of Normandy Pro 13oz.)
	Printed hand sample

	Unprinted hand sample

	Sample roll

Strip Mesh Plus (8 oz mesh with PVC backer)
	Printed hand sample

	Unprinted hand sample

	Sample roll

UltraMesh Plus (8 oz mesh, same as Strip Mesh Plus but without backer)
	Printed hand sample

	Unprinted hand sample

	Sample roll

UltraCotton C370 (11 oz %100 natural cotton with a heavy canvas texture)
	Printed hand sample

	Unprinted hand sample

	Sample roll

Please specify other samples needed and their quantities, such as printed or unprinted hand samples of a specific product or sample rolls (for test-printing) of a specific product. Sample rolls are typically 30" x 25'. For sample rolls, please specify matte or gloss finish where applicable. *Ultraflex materials are not for Aqueous printers.

Shipping details:

*Your Company:

*Your First Name:

*Your Last Name:

*Attention
(receiver's name):

*Company Address:

*City: *State: *Zip:

*Phone#:

ext.

Fax#:

*Email Address:

Web Address:

*Printer(s) your Company has (specify Name and Model):

*Who do you currently purchase your sign material from?

-We will process and ship your request within 24 hours. If you are not contacted, your request will ship to the address provided.

*Please select a shipment destination and a carrier:

(NOTE-choose a carrier for which you can provide a valid account #)

Thank you! For help with samples please call the Marketing Department at (973) 627-8608 ext. 119