Request for Samples Order Form - South

Use this electronic form to order your sample requests for customers.

The form will be submitted to customer service department for processing. If you have any questions about your order, contact your inside customer service partner.

Salesperson Information

Provide your information

Sales Representative Name

First Name*

Last Name*

Required*

Shipping Information

New Opportunity
Required*

	Yes
	No

Organization requesting samples

Required*

Account Number

Required*

Contact Name

First Name*

Last Name*

Questions pertaining to this order at the parish

Shipping Address

Street 1

Street 2

City

State

Zip

Materials will ship to the organization address in CRM unless indicated here

Contact Phone

Contact's E-mail

AIC Parish

AIC Parish Sample Kit

	AIC Parish Sample Kit- Tier 1 CU9524
	AIC Parish Sample Kit- Tier 2 CU9525
	AIC Parish Sample Kit- Tier 3 (upon special request of customer) CU9992
	AIC Parish Sample Kit- Grade 7/8 CU9993

AIC Parish Customized Sample kit, please list the CU numbers of desired materials to be sent

AIC for Young Adolescents

AIC for Young Adolescent Sample

AIC School

AIC School Sample Kits

	AIC School Sample Kit- Tier 1 CU9621
	AIC School Sample Kit- Tier 2 CU9622
	AIC School Sample Kit- Tier 3 (upon special request from the customer) CU9995
	AIC School Sample Kit- Grade 7/8 CU9994

AIC School Customized Sample kit, please list the CU numbers of desired materials to be sent

VEC

VEC Sample Kits

	VEC Sample Kit - Tier 1 CU9613
	VEC Sample Kit - Tier 2 CU9996
	VEC Sample Kit - Tier 3 (upon special request from the customer) CU9997

VEC Parish Customized Sample kit, please list the CU numbers of desired materials to be sent

EWC Samplers

	EWC Sample Pack #1 - Catechist-Led Model CU9985
	EWC Sample Pack #2 - Parent-Led Model CU9986
	EWC Sample Pack #3 -Combined Model CU9984

EWC Confirmation RO Samplers

EWC Confirmation RO Early Sample Pack - #CU9918

ECC Samplers

	ECC Sample Pack #1 – Catechist-Led Model #CU9906
	ECC Sample Pack #2 – Parent-Led Model #CU9919
	ECC Sample Pack #3 – Combined Model #CU9920

Allelu

Allelu Sample Kits

	Allelu 3 yr old Kit X1368
	Allelu 3 yr old Bilingual Kit X1364
	Allelu 4 yr old Kit CU X1367
	Allelu 4 yr old Bilingual Kit CU X1365
	Allelu Kindergarten Kit X1369
	Allelu Kindergarten Bilingual Kit X1366

Faith Fusion

Faith Fusion Samples

	Faith Fusion Elementary SE X1447
	Faith Fusion Elementary CE X1448
	Faith Fusion Elementary Bilingual SE X1622
	Faith Fusion Elementary Bilingual CE X1623
	Faith Fusion Junior High SE X875
	Faith Fusion Junior High CE X936
	Faith Fusion Junior High Bilingual SE X1126
	Faith Fusion Junior High Bilingual CE X1128

Parent Letters

	Parent Letters - English X1088
	Parent Letters - Spanish X1370

CTC

CTC Sample Kits

	Reconciliation Kit CU4914
	Eucharist Kit CU 4915
	Intermediate Kit CU4916
	Intermediate Bilingual Kit CU9107
	Confirmation Younger Adolescents Kit CU4917
	Confirmation Older Adolescents Kit CU4918
	Reconciliation Bilingual Kit- CU5085
	Eucharist Bilingual Kit CU5086
	Confirmation Bilingual Kit CU5090

Offertory Solutions Product Info Request

	Faith in Action Websites
	Catholic Parish Apps
	Increased Offertory Program

Special Instructions or Additional Items

Please enter any special instructions or other materials needed