Sample Order Form

Flintile Inc. has set up this online form for ordering Flexco and other brands’ samples for your convenience. To place an order for samples, please fill out the from below thoroughly and in it’s entirety.

Your Name:*
E-mail:*
Phone:*
-
Company:*
Company address:
Project Name: (Type "Showroom" if for your sales floor)*
Project Evaluation:
Project Start Date:
Which Samples Do You Require?:*
If You Selected Other, Specify Here:
How Do You Wish To Receive Your Samples?:*
Type the characters you see here:

* Indicates required fields