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CONTACT INFORMATION * = required
Company      
*First Name   *Last Name  
*Address  
*City   *State    *Zip  
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E-mail   E-mail confirm  
 
PROJECT INFORMATION
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Project City?  
Project State?  
Project Description/Details?  
 
COMPANY  INFORMATION
How did you hear about Avonite Surfaces?  
What category best describes your job function?  
Which best describes your firm?  
Types of projects you work on?  
   
SAMPLE INFORMATION


Most orders usually ship within 24-48 hours. For special requests, please allow an additional five days.

Standard Size Requests Special Size Requests
Color
Size 2.35" x 1.7" Size
Qty. Qty.
       
       
Comments
SHIPPING INFORMATION


Samples are sent by Federal Express Ground.  To request other shipping arrangements, please indicate type and provide your account number below.
Account number is REQUIRED for other shipments.

Federal Express Ground

OTHER:
Federal Express Overnight
Federal Express 2 Day Air


Account No
 
   


 
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