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Dow Corning Customer Color Match Program Request Form

Notice to the Submitter:
Each color request for each product requires a separate form. Return a completed form and a 3" square substrate sample (if substrate is solid-colored) or a color chip (if the substrate is multi-colored). Brilliant hues or metallic colors may not be matchable. Retain a copy of this form for your files.
Verify/enter your contact information:
Submitter's Name:
Submitter's Phone:
Submitter's Fax:
E-mail Address:*
Verify/enter your shipping information:
Blank or missing shipping information may cause a delay in shipment.
First Name:*
Postal Code:*
Additional Information:
Project / Job Name:
Product to be matched (Dow Corning® brand silicone products, check one):*

If other, specify:
Wet Sample Required?:

Substrate/Color Ref #:
Sq. Ft./Estimate:
Linear Ft./Estimate:
Container to order:

Distributor's Name:
Dow Corning Sales Representative:
Special Instructions:
Return Name:*
Return Phone:*
Return Fax:*
Return Address:*
To Approve a Color Match and Place an Order:
There will be acceptance and approval of a color match when the customer returns the color request and approval form with an approval signature or an order is placed with the above "Color Match I.D. Code" used. To place an order, call your Dow Corning distributor.
The Color Match I.D. Code MUST be indicated with the order.
Export Control Information
Dow Corning products, information and related technologies are subject to export control regulations. To review the export control information, please see our Export Control Statement.

For and on behalf of my company, I understand and agree to abide by the Export Control Statement outlined in the document:*

Europe VAT Number:
India TIN Code:
India IE Code:
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