Order Sample from ATTEFF

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Order Sample

Registered ASI, PPAI, and SAGE distrubutors can fill out the sample order form below to place a sample order. Samples are billed at EQP NET plus shipping, standard shipping is UPS-Ground. If expedited shipping or other shipping method is required, please specify in the "Shipping Method" section. For additional questions or requests, please contact ATTEFF customer service.

Bill To Address:

Bill To Company:

* Company is required.

Contact:

First Name: Last Name: * First name is required.* Last name is required.

Address Line1:

* Address is required.

Address Line2:

Bill To City:

State: Zip: * City is required. * State is required. * Zip code is required.

ASI/PPAI/SAGE #:

ASI

SAGE

PPAI

* An ASI, SAGE or PPAI number is required.

Phone #:

Fax #: * Phone number is required.

Email:

* Email is required.

Ship To Address:

Same As Bill To Address

Ship To Company:

* Company is required.

Contact:

First Name: Last Name: * First name is required. * Last name is required.

Address Line1:

* Address is required.

Address Line2:

Ship To City:

State: Zip: * City is required. * State is required. * Zip is required.

Receiver Phone #

(required by UPS and FedEx for expedided shipping):

Order Detail:

Item Number, Color, and Quantity:

* Item info is required.

Blank or Random Sample:

Blank

Random

(Random sample is not always available, we will ship blank if no random sample is available.)

Shipping Method:

* Ship method is required.

Freight Charges:

Bill Me

Freight Collect

Third Party Account

Account #:

Additional Instructions:

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