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Sample Application

Samply Inquiry

Date:	*	Number:
Company name：	*
Address：	*
Project name:		Tel:	*
E-mail:		Fax:
Purchasing contact:		Extension number:
Development contact:		Extension number:

If you already know the company's product model, please fill in the following form (Note: a model can only apply for a maximum of 2 samples).

Number	Application model	Ever used product model or brand	Each Usage	Remark
1
2
3
4
5
6

If you do not know the company's product model, you can fill out the specific needs of the product performance, application environment：

Compatible with what brand products ：

Size requirements ：

Packaging requirements ：

First order quantity (very important) ：

Estimate annual purchase usage ：

First order time (very important) ：

The Last product uesd ：

The duration of the project ：

Suggestions for our company ：

(The above information is required. Only in this way can allow us to provide more comprehensive service for the customer, choose closer to customer demand for products. )