We are pleased to send you our free samples. In order for us to send you right ones, please tell us necessary
information about your applications and contact Information by calling toll free 888-308-9988, by faxing to
909-598-8636 or emailing to email@example.com
Sample Request Form:
Contacting Person’s Name:__________________________________________________________
Phone: ( )____ -__________ Fax: ( )____-_____________
What colors and/or flavors are you looking for? (Please be specific: Natural? Artificial? Red? Strawberry- red?
Cherry-red? purple? Orange? Yellow?…)
What is/are the application(s) of this/these color(s) ( Please be specific: Ready-to-Drink beverage?
Beverage mix? Tomato sauce? cake? cheese? hard candy?…)
What forms do you need? Please circle items you need: liquid Powder water soluble Oil soluble
What is the pH value of your product?
Requirements for colors: (be specific. examples: Kosher, organic suitable, shelf life, acid proof, heat-stable,
What is the processing temperature? oC or oF for minutes
What is the package material?
Is the package: opaque or transparent?
What is the deadline for us to send you samples?
Please fax to 909-598-8636 or
email it to: firstname.lastname@example.org