Sample Request Form

Aker Technology USA Corporation
15757 Pines Blvd, Suite 152
Pembroke Pines, FL 33027
Phone: 954.483.4208
Email: info@aker-usa.com

    Your Information

    Type of Customer:

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    Ship Method

    All Samples are shipped FOC within USA

    Outside USA please provide the following:

    Date Samples Required

    Project Information

    Estimated Date for Prototype

    Estimated Production Date

    Samples Needed

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    Sample Notes