Sample Request

    Please complete this short form below for each desired color match. Submit a copy, and send it to us with two identical “color standards.” The color standards should be coated pieces that accurately represent the desired color, gloss level, and substrate of your finished product. One color standard is used during the matching process while the other is left untouched and retained for future batch-to-batch comparisons. A member of our staff will contact you once we have received your color standards and completed Sample Request Form.

    Name: (required)
    Title:
    Company: (required)
    Address:
    Address Line 2:
    City: (required)
    State/Prov.: (required)
    Zip/P.C.:
    Country:
    Phone: Ext.: (required)
    Fax:
    E-mail: (required)

    Color Name/Description (and part # if known):

    Type of Container (Check all that apply):
    12 oz. Aerosol
           Approximate Usage Qty. (100 min.):
    6 oz. Aerosol
           Approximate Usage Qty. (100 min.):
    Brush-in-Lid Bottle
           Approximate Usage Qty. (100 min.):
    Paint Marking Pen
           Approximate Usage Qty. (100 min.):
    Other (Describe in “Special Notes” below)
           Approximate Usage Qty. (100 min.):

    Approximately how long will above Order Quantity last? Months

    Additional Information
    Type of surface to be touched up:
    Bare metalPaintedOther
    Describe:

    Primary Light source? Check all that apply. (If more than one, list in “Special Notes”.)
    DaylightFluorescentIncandescent

    Resin system type? (see notes below)
    No preferenceEnamelLacquer

    Aerosol spray pattern?
    FanRoundN/AOther
    Describe:

    Aerosol carton size?
    12-pak6-pakN/AOther
    Describe:

    Aerosol cap type?
    Small 1 inch stacker capLarge double-shelled (DS) capN/A

    Labeling Requirements
    No preference (Custom-Pak stock label)
    * Semi-private label using your company logo
    * Multi-color private label
    * – One-time label development charges will apply

    Special Notes?
    (Provide details about your Sample Request, i.e. performance requirements, VOC issues, etc.)

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