Every Sip In-Store Retail Tasting Request 
Please submit this form to request a single tasting event in a retail account. 
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Email *
Requestor Name  *
Requestor Phone *
Billing Manager Name  *
This is the person who will receive or approve the invoice.
Billing Manager Email Address *
This is the person who will receive or approve the invoice.
Billing notes 
Please include any special billing instruction here. 
What city and state will your tasting take place? *
Which Distributor? *
Date of Tasting *
MM
/
DD
/
YYYY
Back-up dates
Start Time *
Time
:
End Time  *
Time
:
Location Name *
Location Address (including city and state) *
Store Manager with email and phone *
Supplier Name  *
Products for tasting (list all products to be sampled) *
Are any mixers needed for your tasting?
Clear selection
List mixers and if they will be left or if specialist should purchase.
How will product samples be handle?
Samples will be located in...
Promotional tools available
Supplies specialist will need besides cups and openers
Is specific attire required? If yes, please describe
A copy of your responses will be emailed to the address you provided.
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