Airguard® A CLARCOR Company

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	Customers are our Number One Priority. All of us at CLARCOR Air Filtration Products, Inc., representing the Airguard Brand, look forward to serving you.	3807 Bishop Lane • P.O.Box 32578 Louisville, KY 40232 Phone: (502) 969-2304 ext. 1 Toll Free: 1-866-247-4827 Fax: 1-800-784-3458 mailbag@airguard.com

Airguard's Product Sample Order Form

Please complete this form to order Airguard product samples.

*Field Required

*Customer PO Number:

*Order Date:

*Sold To:

Name:
Address:

City:	State Zip Code
Phone:
Email:

*Ship To:

Name:
Address:

Phone:
City:	State Zip Code

	*Item Number	*Description	*Size	*Price 50% discount	Case Qty
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Special Instructions:

This form is directed to the Customer Care Department of
CLARCOR Air Filtration Products, 3807 Bishop Lane, Louisville, KY 40218
My Fax: 1-866-601-1809 - general Fax; 1-800-784-3458
Laura Whaley

To locate a distributor for your area visit the distributor locator section of our website.