Request a Sample

Sample request form

Name(Required)

Email(Required)

Zipcode(Required)

How do you plan to work with us?(Required)

Direct with a US Brick Sales Rep

Through a Distributor, Builder, Designer or Architect

I’m a Designer, Architect, or Builder Interested In Using Your Products

Have Not Connected with You Yet

Please provide the name of the sales representative or third party you are working with. If you haven’t connected with us yet, please type N/A.*(Required)

Select the Brick Samples You're Interested In:

Collection-Location(Required)

Brick(Required)

Add another product

Looking for stone or paver samples?

Please specify which product(s)

Address(Required)

Untitled(Required)

Brick(Required)

Comments

This field is for validation purposes and should be left unchanged.