Please enable JavaScript in your browser to complete this form.Routered Doors & Accessories Sample Request FormPlease fill out this form to place a customers sample request for Routered Doors & Accessories - please contact nathanrizk@tesrol.com.au with any issues regarding this form. Customer DetailsCustomer: *Lead Contact: *FirstLastAddress: *Address Line 1Address Line 2CityState / Province / RegionPostal Code400mm x 290mm Sample Door RequestNumber of Samples Door(s) Required:OneTwoThreeFourDoor One - Design:Door One - Edge Profile:Door One - Thickness Required:16mm18mm21mm25mm32mmDoor Two - Design:Door Two - Edge Profile: Door Two - Thickness Required: 16mm18mm21mm25mm32mmDoor Three - Design: Door Three - Edge Profile: Door Three - Thickness Required:16mm18mm21mm25mm32mmDoor Four - Design:Door Four - Edge Profile:Door Four - Thickness Required: 16mm18mm21mm25mm32mmSample(s) Required By:AccessoriesRaw Capping Required: (1 qty x 300mm piece) FederationSculpturedColonialCountryBevelDental SquareDental RoundDental BaseRaw Skirting Required: (1 qty x 300mm piece)SK 1SK 2SK 3SK 4Does the Capping or Skirting need to be larger than 300mm? If so, this may incur extra charges and is subject to approval.YesNoDoes the customer require any of the below? If so, this may incur extra charges and is subject to approval.CorbelsColumnsBlocksFretworkIf they require additional samples, what do they require and why? Delivery MethodHow would the customer like these sample delivered? *NSW Local: Pick-up from Wetherill ParkVIC Branch: Put on exchange truckQLD Branch: Send or post out samplesTAS Customer: Post out samplesNewcastle: Send on truck to RossRegional Customer: Send or post out samples directlyOther: Please Specify BelowOther Delivery Option? Please indicate how and why. Sales Representative DetailsRequested by: *FirstLastEmail: *Date of Sample Request: *EmailSubmit