Airguard® A CLARCOR Company

	Home The Airguard Difference Inquiry Form Contact Us
	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

Non Credit Approved Customers
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
1
2
3
4

5	CC TYPE	Credit Card Number	AMERICAN EXPRESS, VISA & MASTER CARD ONLY
6	Expiration Date	Company Name	Card Holder Name

Special Instructions:

This form is directed to the Customer Care Department of
CLARCOR Air Filtration Products, 3807 Bishop Lane, Louisville, KY 40218
My Fax: 1-866-607-5380 - General Fax; 1-800-784-3458
Shawn Avdevich

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