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Sample Request To request glass samples*, please fill out the information below. A World Glass Representative will contact you to arrange shipment. Which products are you interested in? Architectural Painted Glass - BellaMuro ($20) Clear Patterned Glass - VistaArt ($45) Acid Etched Glass - BellaDesign ($20) Glass Blocks ($12) Dichroic Glass - DichroArt ($20) Architectual Binder ($45) Cast Glass - StudioCast ($60) Printed Catalog (FREE) Type of Business: Choose from below Architect Contractor Designer Distributor Exibit and Display Glass Fabricator/studio Glazing Contractor Individual/Residential Millwork Contractor Other Name*: Title: Company*: Delivery Location: Residential Delivery Business Delivery Address*: City*: State*, Zip*: Choose from below Canada & Int'l AE Alaska Alabama AP Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachussets Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island Puerto Rico South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington West Virginia Wisconsin Wyoming Telephone*: Fax: Email*: Website: Project Status: Current Immediate Future No Project - Request Info Comments/Special Instructions: I would like to sign up for World Glass E-news. *World Glass is pleased to provide a free set of glass samples to our Architect and Designer Customers. Sample Size vary by product.

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