Sample Order Form

Sample Policy: All samples are billed at End-Column. Shipping and handling will also be applied if no account number is provided. All samples are random; styles and colors on items not available may be substituted. Standard shipping is UPS ground if not indicated.

1. Account # or ASI #

If you are not a promotional products distributor, please contact a specialized promotional products distributor in your area.

2. Bill to Information:

Company Name:


City: State: Zip:

Telephone: Fax:


3. Ordered By:

Name of Individual:

Purchase Order #:

4. Ship To Information:

Company Name:



City: State: Zip:

5. Ship via/ Method: UPS Fed-Ex Other

6. Date Required/ In Hands Date:

7. If Applicable: Ship via Account #

8. Bill: Recipient or 3rd party


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