Request Sample

Gaylord Chemical can provide product samples to qualified users of chemical products. Please fill out the Sample Request form to initiate the sample request process.

After reviewing your request you may be contacted for more information about your application. Gaylord Chemical Company reserves the right to deny any product sample request. Sample request will be considered for qualified commercial and research purposes only.

All sample requests are subject to an internal review and individual approval.

Once approved, product samples will ship in a few days and you will receive an email message with sample tracking information.

Please enter your sample request in the following form and click the button marked “Submit” when you are finished.

Note: Fields with asterisks must be completed for this form to be submitted.