Hero X24 Series Sample Request

Sample Request Form

X24 Series
Clinic Code
Sales Rep
Sales Rep Email
ITEM ID
Entity Type*

POLICEFIRESHERIFFEMSOther / Not Listed
Department Name*
Department City & State*

STREET ADDRESS

Street Address Line 2

CITYSTATE

ZIP CODE
STATE
Your Name*
Title*

ASSISTANT CHIEFCAPTAINCHIEFCHIEF DEPUTYDEPUTYDISPATCHFIRE MARSHALLIEUTENANTOFFICERSERGEANTSHERIFFOTHER/NOT LISTED
Email*
Cell Phone*
Ship To*
SHIP TO TEXT
Business/Department Name*
Ship To Attention*
Shipping Address {We cannot ship to a PO Box}*

Garment Type*
Garment Type Text
Garment Size (24H)*
X24 Hoodie Color Code
Garment Color (24H)*

Heather/BlackHeather/NavyHeather/RedHeather/RoyalHeather/Vegas
Garment Size (24Q)*
X24 Quarter Zip Color Code
Garment Color (24Q)*

BlackGraphite
Garment Size (24F)*
X24 Full Zip Hooded Jacket Color Code
Garment Color (24F)*

Black/BlackGraphite/BlackNavy/GraphiteRed/BlackRoyal/BlackVegas/Black
Garment Size (24LF)*
X24 Ladies Full Zip Color Code
Garment Color (24LF)*

Heather
Garment Size (24MSP)*
X24 Mens Polo Color Code
Garment Color (24MSP)*

BlackGraphiteNavyWhite
Garment Size (24LSP)*
X24 Ladies Polo Color Code
Garment Color (24LSP)*

BlackWhite

Polo Bar Color*

NO BAR WANTEDBLACKBROWNCHARCOALDOT YELLOWFOREST GREENGRAPHITEGRAYHOT PINKKELLY GREENMAROONMICHIGAN GOLDNAVY BLUEND GOLDORANGEREDROYAL BLUEVEGASWHITEYELLOW
SIZE
FRONT STYLE
Upload Logo

Cancelof
-OR- Take Photo of Logo
-OR- Describe Custom Logo Here
For Example: Maltese logo on file from previous orders
X24 Personalization*

Yes, I want to personalize my sample.No, I do not want to personalize my sample.
Back Personalization (Printed)*
Example: J. SMITH --or-- CHIEF SMITH --or-- EST. 1901
NAME PERSONALIZATION
## PERSONALIZATION

Rows	TEXT
TOP BAR (Example: SOUTHRIDGE)
MIDDLE WORD (Example: POLICE)
BOTTOM BAR (Example: DEPARTMENT)

Rows	TEXT
TOP LINE TEXT (Example: SOUTHRIDGE)
BOTTOM TEXT (Example: AMBULANCE)

Rows	TEXT
TOP LINE TEXT (Example: SOUTHRIDGE)

Notes
Rep Notes
All samples are subject to verification. One sample a year per department.

Samples are not shipped out immediately.
Should be Empty:

Sample Request Form