Marketing Materials Request FormPlease enable JavaScript in your browser to complete this form.Need Delivered By: *Please provide a specific date (please do not request ASAP). Normal lead time is 5 to 7 working days. **Any expedited freight charges must be paid by customer or sales representative. For expedited shipments, a FedEx or UPS account number needs to be provided in the comments section.End-user or Project *Reason samples neededManufacturer Rep Name *FirstLastAgency: *Email *Phone *______________________________________________________________________________________________________________Please check material(s) needed. Please add any details in the Special Requests box below, including quantities of each if more than one.Bag of FlakeBag of ResinSection of PolytubeRevolution Bag One PagerDisplay Case (polytube, flake, resin). 1st free, $5/add'lRevolution Bag box (empty, for trade shows)Recycling Visual BannerSmall (8.5 x 11)Medium (11 x 17)Revolutionary Process Banner*Small (8.5 x 11)Medium (11 x 17)Large (33 x 79 floor stand)*Large banner must be returned or borrower is subject to a $100 charge.Special Requests: Please enter any literature/selling aids needed (with quantity) or custom requests. For each stock item checked above, we will send one unless otherwise requested here.______________________________________________________________________________________________________________Ship to: *NamePhone *Contact NumberCompany *Shipping Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeComments. For expedited shipments, please enter FedEx or UPS account number below.Questions? Email Customer Service at customerservice@revbag.com.Submit