Request a Sample

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Phone
This field is for validation purposes and should be left unchanged.
Please select ONE of the following sample sets*
- Clear Cup and Candle
- Purple Cup and Candle
- Red Cup and Candle
- Blue Cup and Candle
- Green Cup and Candle
- Smoke Cup and Candle
- White Cup and Candle
Please enter the address where the sample is to be shipped via Canada Post:
Organization Name*
Contact Name*
Contact Title*
Address*
City*
State/Province*
Phone*
Email Address*
Postal Code*
Date Sample Required*
MM slash DD slash YYYY