Sample Request & Order Form

Thank you for submitting your sample request to Dutch Treat Foods. All sample requests must be approved in advance by an authorized representative of Dutch Treat Foods prior to fulfillment. If you have authorization, please fill out the form below in order to provide us with the necessary information to fulfill your sample request. Should you have any follow up questions or concerns, please email them to info@dutchtreatfoods.com or call our main line at 616.772.5921 and a member of our team will assist you.

Name of Company Representative Submitting Request *
Name of Company Representative Submitting Request
Representative Phone *
Representative Phone
Please indicate the size container in which you would like the product samples packed
Please list each product you would like included in your sample case and separate each product in the list with a semi-colon. If you are requesting a standard sample case that we provide to your company on a regular basis, please list "Standard Sample Case."
Please indicate the number of sample containers you would like of the above listed products OR if you are requesting a Standard Sample Case, please indicate the number of sample cases you are requesting
Date Company Representative Needs Samples *
Date Company Representative Needs Samples
PLEASE NOTE: A seven day lead time is required in order to ensure timely fulfillment
Please provide information regarding the date and time Company Representative will pick up the samples from Dutch Treat Foods or how Dutch Treat Foods should ship samples to Company Representative
Please list special instructions or additional information relevant to sample request