Sample Request Form

A maximum of "TWO" different products may be selected. We will sample you two panels of each at no-charge. Samples are sent prepaid ground EXW Chandler AZ in the United States. When sent outside the United States, international requestors will be responsible for any customs and duty charges. Appropriate end-use documentation may be requested by Rogers Corporation before samples will be sent to international customers. If you are a University Professor or Student please submit your request through our University Program form.

"Rogers Corporation abides by all U.S. government laws and regulations, including those involving U.S. Export Controls. Some Rogers products, may require export licensing in order to be sold outside the United States. To this end, Rogers Corporation will monitor, control and sell its products within established guidelines that may require validated end use/end user information. Upon review of your request, our closest Rogers Corporation office will contact you regarding the requirement."

First Name:
Last Name:
Company:
Address:
Address2:
City:
State:
Zip:
Country:
Email:	A confirmation is emailed to this address.
Phone:
Comments:
Application:
Start Date:	Select the projected start date of the project.
Square Footage:	Select the projected square footage of the project.
Mailing List:	Yes, I would like to be placed on your email list.

Quantity	Grade	Thickness	Copper Cladding	Panel Size
	RO3003			12" x 9"
	RO3006			12" x 9"
	RO3010			12" x 9"
	RO3203			12" x 9"
	RO3210			12" x 9"
	RO4003C			12" x 9"
	RO4350B			12" x 9"
	RT/duroid 5870			9" x 6"
	RT/duroid 5880			9" x 6"
	RT/duroid 6002			6" x 6"
	RT/duroid 6006			5" x 5"
	RT/duroid 6010			5" x 5"
	TMM3			6" x 6"
	TMM4			6" x 6"
	TMM6			6" x 6"
	TMM10			6" x 6"
	TMM10i			6" x 6"
	ULTRALAM 3850 LCP			9" x 12"
	RO4450F			5 - 18" x 24" Sheets
	RO4450B-DX Prepreg			5 - 18" x 24" Sheets

Note: If the form does not submit, please check above for required fields.