Mayan Pigments, Inc.
500 W. University Ave.
Burges Hall 320
El Paso, TX 79968
Ph: (915) 747-6122  ::  Fax: (915) 747-6007

At Mayan Pigments, Inc., we take pride in listening to our customers and supporting their needs through service, quality, and honesty. Please answer the questions below so that we can determine which information and product samples will best serve your needs.

Name*		Official Job Title
Company Name*		Address
Phone*		Email*
Fax
1. Applications for which Mayan Pigments will be evaluated.
2. When do you expect the application to be commercialized?
Month    Year
3. What colors will be required for your applications?
4. What is the potential annual usage rate if Mayan Pigments are qualified for use?		lbs.
5. What is the minimum sample size that you will need for evaluation purposes?		lbs.
6. How did you hear about us?*		Please Select Web Search Direct Mailer Trade Show Trade Press Other
7. Questions / Comments / Suggestions
*Denotes a required field.