A representative will be contacting you prior to sending samples to verify and request your valid US Tax ID#, if not already on file.
Please be advised that Qosina can only sell to the industry.
We do not sell to the general public
.
Sample Request Form
* Required Fields
Salutation:
First Name:
Last Name:
Title:
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Mrs.
Ms.
Dr.
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Company:
Address:
Address Line 2:
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City:
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Zip/Postal Code:
Country:
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Phone Number:
Fax Number:
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E-mail Address:
Samples Requested:
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Delivery Method:
Shipping Account Number:
*(Please fill in for express delivery)
Standard US Mail (Free)
FedEx First Overnight by 8:30 am
FedEx Priority Overnight by 10:30 am
FedEx Standard Overnight by 2:30 pm
FedEx 2nd Day
FedEx Saver (3 Days)
FedEx Ground
FedEx International Priority
FedEx International Economy
UPS Red Early AM by 8:30 am
UPS Red by 10:30 am
UPS Red Saver by 2:30 pm
UPS Blue (2 Days)
UPS 3rd Day
UPS Ground
UPS Standard to Canada
UPS Expedited
UPS Worldwide Saver
UPS Express
UPS Express Plus
DHL International
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Thank You.