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If you are a potential new distributor or one of our current accounts we want you to get everything you need to make that sale or make that buying decision! Please do utilize this form. Samples are billed at EQP plus freight. If you do not have an account with us please note that in the COMMENTS SECTION!  We will call you for your credit card number. If you provide your Shipping Account #, there is no charge for samples if the total value of your sample request is less than $6.00. Required fields*     BILL TO Name* Company* Address* City State Zip* Phone* Fax Email*     You are? Active Account ASI Member Account or ASI# Other Assn. & Number   SHIP TO (if different) Name Company Address City State Zip Phone Fax Email   Preferred Carrier FEDEX UPS Routing Requested Standard Ground 2nd Day Delivery Next Day Delivery Shipping Account#     Quantity Item Number Color Description Price Any Messages? Additional Materials Needed?