SNF Sample Request |

SNF Sample Request Form

Samples will be shipped via FEDEX GROUND unless requested otherwise.

Maximum sample sizes to be processed through the SNF Sample Room are 1 gal. for liquids/emulsions and 10 lbs. for powders.

All liquid/emulsion samples 5 gallons and above, and all powder samples 55 pounds and above should be submitted to Customer Service as a standard order.

"*" indicates required fields

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Date Submitted:

Delivery Date Requested:*

Request Originator:*

Requester Email*

Is the person completing this form (Requester) an SNF Salesperson?*

Yes

Is this an Oil & Gas Sample Request?*

Yes

SNF Sales Representative Name*

Sample Request CANNOT be fulfilled without listing your SNF Sales Representative.

SNF Sales Representative Email*

Additional Email(s) NOT INCLUDED ABOVE to Receive Shipment Notifications:

Enter One email address per line.

Shipped From:*

Name of Receiver:*

Receiver Phone Number:*

Receiving Company Name:

Delivery Address:*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Requested Samples*

SNF Product Name

Labeled As

No. of Samples

Quantity*

Unit of Measure

SNF PRODUCT NAME: Flopam XXX or Clarifloc XXX (Examples)
NO. OF SAMPLES: Number of samples to be sent per product.
QUANTITY: Number of ounces/liters/pounds/etc. per sample. MAXIMUM 1 gallon for emulsions/liquids and 10 pounds for powders.
UNIT OF MEASURE: Ounces/liters/pounds/etc.
CLICK + TO ADD SAMPLES.

Sample Kit Request

Yes

Requested Sample Kits

Sample Kit Name

No. of Kits

Shipping Method:*

Comments / Special Instructions (If Any):

SUBMIT BUTTON WILL APPEAR AFTER CHECKBOX BELOW HAS BEEN CLICKED*

Sample Request Form is Complete

SNF Sample Request

SNF Sample Request Form

Samples will be shipped via FEDEX GROUND unless requested otherwise.

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