Sample Request Form - Distributors

The Sample Request portal will allow distributor representatives to request sample products. With approval, samples will either ship from Comtrend, or from the distributor with full credit.

Are you a Service Provider?

1) Distributor Rep Information.
2) Distributor Name
3) Company receiving sample(s)
4)Shipping Information
5) Samples Request - (3 Maximum, otherwise Request Exception)
6) Reason for Sample Request (background)
7) Competitive & Additional Information
8) Sample Source (Required)
9) Did you confirm that the customer will test and evaluate within two weeks of receipt?