A30 Breathable Splash & Particle Protection Coverall A30 Breathable Splash & Particle Protection Stretch Coverall   A40 Liquid & Particle Protection Coverall   G10 Grey Nitrile Glove   G10 Blue Nitrile Glove   G40 PURPLE NITRILE* Foam Coated Glove   G40 Latex† Coated Glove   G40 Polyurethane Coated Glove   G50 Mechanics Glove   G60 PURPLE NITRILE* Cut Resistant Glove	A60 Bloodborne Pathogen & Chemical Splash Protection Coverall   A70 Chemical Spray Protection Coverall   G80 PURPLE NITRILE* Chemical Resistant Glove	V10 Standard Eye Protection   V20 Comfort Eye Protection   V30 Flexible Eye Protection   V40 Contour Eye Protection   V50 Contour Eye Protection	M10 Particulate Respirator N95 M10 Particulate Respirator N95 with valve M20 Particulate Respirator R95 with valve M20 Particulate Respirator P95 with valve M30 Particulate Respirator N99 with valve

____________________________________________________________________________________________

Request Form

*Name:   *Position/Title: *Business Address:   *Company: *City:   Industry: Automotive Chemical                                  Glass Handling/Metal Working Plumbing Transportation Machinery Other *State/Province:    --    AB AK AL AR AZ BC CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MB MD ME MI MN MO MS MT NB NC ND NE NF NH NJ NM NS NT NV NY OH OK ON OR PA PE RI SC SD SK TN TX UT VA VT WA WI WV WY YT PQ    *Zip/Postal Code:    *Email: *Business Phone: (xxx-xxx-xxxx)

How many workers use Safety PPE in your facility?    Please select the product(s) you would like to sample (two item limit/customer location):         Apparel           Eye Protection           Gloves           Respirators   What Apparel products do you currently use at your facility?   What Glove products do you currently use at your facility?    Which Eye Protection products do you currently use at your facility?    Which Respiratory Protection product(s) do you currently use?    What type of potentially hazardous material do your workers handle?         Glass           Chemicals           Wood           Metals           Blades           Dust           Other(Please Specify)   *What is your role in the purchasing process? (Please select one option)         Purchase           Specify           Recommend           None (Person responsible for purchasing)   LIMITED OFFER -- Two-item limit per customer location.

Check to receive product updates, special offers and news from KIMBERLY-CLARK PROFESSIONAL*.

Sample quantities are limited.  Offer limited to U.S. and Canada business addresses only.

* Required fields for sample ordering. Your visit to this site and use of the information hereon is subject to the terms of our Legal Statement. Please review our Privacy Policy. ® Registered Trademark and * Trademark of Kimberly-Clark Worldwide, Inc. © 2006 KCWW All Rights Reserved. †This product contains natural rubber latex, which may cause allergic reactions.