PRO-MIX® CONNECT™ SAMPLE REQUEST FORM We are pleased with your interest in our mycorrhizal inoculant. Howerver, as we receive many requests for samples, please fill out this form for your request to be considered. Question Title * 1. Contact info Name Company Address City/Town State/Province ZIP/Postal Code Country Email Address Phone Number Question Title * 2. If you have an Instagram account, please give us your account name Question Title * 3. Tell us how you became aware of PRO-MIX® CONNECT™? Instagram Sales representative Video Already customer Trade Show Friend Question Title * 4. Do you already use PRO-MIX products? If so, which one(s)? PRO-MIX HP PRO-MIX BX PRO-MIX HPCC PRO-MIX MP ORGANIK PRO-MIX PGX PRO-MIX FPX PRO-MIX PG Question Title * 5. Do you grow hemp or cannabis? Cannabis Hemp Question Title * 6. How many plants do you grow and on how much space (sq. ft. or acres)? Question Title * 7. Notes Question Title * 8. Do you have a preferred hydro store? Question Title * 9. I would like to received the latest news, promotions and tips. Yes No Thank you for your interest. Please note that we are very grateful for your interest in our products. To find more about our PRO-MIX® CONNECT™ product, please take a look at this time: try.pthorticulture.com/connect/ Done