Literature & Sample Request Form

**ORDER IS NOT PLACED UNTIL YOU HIT "SUBMIT" AT BOTTOM OF PAGE

Ordered By:	Rep	Dealer			Ship To:	Same as Ordered By
*First Name					*First Name
*Last Name					*Last Name
*Company					*Company
*Address					*Address
*City		*State	*Zip		*City		*State	*Zip
*Email					*Email
*Phone	( ) -				*Phone	( ) -

*Required Fields

SALES LITERATURE:
	QTY:	Item:			QTY:	Item:
		Product Catalog				Tri-fold Brochure
		Gitana Catalog				Quickship Fabrics & Finishes
		Chair Catalog				Storage Sales Sheet
		Tiles Sales Sheet				System 2 Sales Sheet
		Mesa Sales Sheet				Willow Sales Sheet
		Friant Overview Card				The Friant Handbook

PRICE LISTS:			FINISH SAMPLES:
	QTY:				QTY:
Tiles				Metal Finishes
System 2				Quickship Laminates
5 & 10 Day Quickship				Gitana Laminates
				Base Cover Finishes
FABRIC CARDS:			MISC:
Tiles				Complete Binders
System 2 - Standards 1				Clear Plastic "Lunchboxes"
System 2 - Standards 2				Gitana Handle Sample Board*
System 2 - Galaxy			*$25/each - please order through your sales rep.
System 2 - Lightning			DEMO PRODUCT:
5 & 10 Day Quickship			Tiles sample panel
			System 2 Sample panel
6"x6" MEMO FABRIC SAMPLES:
TILES
QUICKSHIP			Note: Demo Product may take 1 week to ship, pending approval.
(or specify:)
SKY
SILKY
SLIDE
STICKS
SPECKS
COMMENTS/NOTES: