Welch's® Natural Jams - Free Sample Kit Form

First Name*

Last Name*

Operation Name*

Address 1*

Address 2

City*

State*

ZIP*

Phone*

E-mail*

How did you find out about the
Welch's^® Sample Pack?*

Would you like to receive news, information
and special offers from H.J. Heinz Company
in the future?*

YesNo

Parent Company Name

Your Heinz Sales Rep

Operation Type*

Primary Distributor Name*

To receive your free samples,
please fill out the form. Your order will be sent to our fulfillment center,
and you will receive your free samples in 2-3 weeks. If you would like more information on Welch's ^® Jams and Jellies, or any other Heinz Portion Control product, contact your local Heinz sales representative.

*indicates required information