SAMPLE REQUEST FORM

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412 220 9247

PRODUCT DETAILS

Please complete this form if you would like to
receive a free sample.

Part #		Description	Qty







Most sample requests are despatched within 24 hours. However, if an item is out of stock, delivery will usually be within 14 days. TERMS & CONDITIONS Free samples are only available on product lines which have the 'Get a Sample' link on the product information page. We reserve the right to decline multiple sample requests, or requests which exceed $100 in value.

YOUR DETAILS * = Required
Mr/Mrs/Ms	*
First Name
Last_Name	*
Job Title
Company	*
Address 1	*
Address 2
City	*
State	*
ZIP	*
Country	(If not USA)
Phone	*
Fax
E-mail	*
Other requests

Tel: (800) 965 9872 Last Updated: 10-Aug-2009 ©OKW Enclosures, Inc. USA. All rights reserved.