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Sample Request Form

To receive samples from any of the manufacturers that EPI Technologies, Inc. represents, please fill out the form below. For more than one part, submit the form, press back and then press Reset.

 
Name:
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Manufacturer:
Part Number: Quantity:

Briefly describe the project or use for the sample.
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If the sample is used in production, how many will you likely use?
Potential:

What other manufacturers are you considering for this part?
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EPI Technologies, Inc. • 41258 N. Westlake Ave. • Antioch, IL 60002
Phone: (847) 395-1776 • Fax: (847) 395-1798 • Email: mikes@epitechnologies.com

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