Please submit this form to PM if you are uncertain how many Subsidized Samples you are eligible for. We will respond within a business day to let you know how many Subsidized Samples and/or Try-On's you can order.

Here are the full Terms and Conditions of the PM Subsidized Sample Program.

1. The number of Subsidized Floor Samples and Try-on's is determined by your rental volume:

   1. 0 Subsidized Sample Outfits (0 to 9 YTD Rentals)

   2. 1 Subsidized Sample Outfit (10 to 49 YTD Rentals)

   3. 6 Subsidized Sample Outfits (50 or more YTD Rentals)

   4. If you are a new account, you are elligible to purchase 1 subsidized sample even if you haven't placed any rental orders.  This order must be placed within 30 days of when your account was opened.

2. Your account must be Active with no past due balance.

3. Your account must not have delinquent merchandise.

4. More Terms and Conditions Apply.

5. Your Business Name:*
6. Your PM Account Number:*
7. Name*
   First Last
8. Email Address:*
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