Jiaogulan Tea Wholesaler: Sample Request Form


		CUSTOM SAMPLE REQUEST FORM

	Jiaogulan Tea
	FAQ's about Jiaogulan
	Products & Services
	Order Info
	Distributors & Resellers
	Testimonials

Design your own Sample Order

Request a quote for samples based on your own needs. Fill out the form below as completely as possible so we may best serve you. All samples are provided at wholesale rates. Shipping and Handling will be added.


Sample Requested
Qty	Jiaogulan Leaf Samples Requested
	Jiaogulan 30gm (1oz) Gift Package ~ $2.79
	Jiaogulan 100gm (3.2oz) Gift Package ~ $6.76
	Jiaogulan 100gm (3.2oz) Cellophane Package ~ $6.76
	Jiaogulan 500gm (16oz) Gift Package ~ $22.06
	Jiaogulan 1kg (2.2lb) Cellophane Package ~ $41.76
Qty	Jiaogulan Leaf Capsules Requested
	Jiaogulan Veggie Capsules (100 @ 500mg) ~ $6.32
Qty	Oolong Samples Requested
	Oolong 30gm (1oz) Gift Package ~ $2.79
	Oolong 100gm (3.2oz) Gift Package ~ $6.47
	Oolong 100gm (3.2oz) Cellophane Package ~ $6.47
	Oolong 500gm (16oz) Gift Package ~ $15.00
	Oolong 1kg (2.2lb) Cellophane Package ~ $33.38
Qty	Mulberry Leaf Samples Requested
	Mulberry 30gm (1oz) Gift Package ~ $2.50
	Mulberry 100gm (3.2oz) Gift Package ~ $6.18
	Mulberry 100gm (3.2oz) Cellophane Package ~ $6.18
	Mulberry 500gm (16oz) Gift Package ~ $13.53
	Mulberry 1kg (2.2lb) Cellophane Package ~ $24.56
Shipping Method Requested
Chose shipping method preferred
Example Rates	1kg Thai Post Priority Airmail is $15.15 (USA) 2kg Thai Post Priority Airmial is $35.47 (USA) 1kg Thai Post EMS is $26.00 (USA)
Reseller Information
Who
Inquiry Type
Distribution Use Ctrl key for multiple selection
How did you find us?	Search Referral: Who? Product Label Other
Search Engine	Which one?
Key Words	Search terms?
First & Last Name
E-mail	Required
Company Name
Title	Position
Website
Phone Number	with Country Code
Address
Reseller Detail Please tell us about yourself, your company, target market and distribution area.
Comments
Jiaogulan Benefits of Interest to you
Please Check Specific Products of Interest	Jiaogulan Leaf Tea ~ Organic Jiaogulan Capsules ~ Organic Veggie Capsules Mulberry Leaf Tea ~ Pesticide Free High Mountain Oolong Tea ~ Pesticide Free
Please Check Product Specifications of Interest	Retail Packaged Product from Jiaogulan Tea Company Retail Packaged Product without labels Bulk Packaged Product in clear cellophane Powdered Product for use in Capsules or Tea Bags
Spam Filter Required for Contact	2+9 = Enter the correct number

We will respond as quickly as possible.

Phone Contact
Ph: (+66) 53-894-708
Mobile: (+66) 86-196-6264
Skype: marc.cofer

Mailing Address
Diana Manilova and John Marcus Cofer
Jiaogulan Tea Company
29/1 Siri Mangkhalachan Soi 13
T. Suthep, A. Muang
Chiang Mai, Thailand 50200

Phone Contact in Thailand
Ph: 053-894-708
Mobile: 086-196-6264

Location
See Jiaogulan Tea Company Map

CUSTOM SAMPLE REQUEST FORM

Design your own Sample Order

Sample Requested

Shipping Method Requested

Reseller Information

We will respond as quickly as possible.