Choward’s Product Request Form

Use this form to request that your favorite store stock Choward’s

Products manufactured by C. Howard Co., Inc.

Your Name:___________________________________________________________

Your Phone:__________________________________________________________

Store Name:__________________________________________________________

Store Location:________________________________________________________

Print out this form, fill out the information, bring it to

your favorite store the next time you go shopping and hand it to the service counter.

Circle the product number(s) you want to request below:

# 03100      Choward’s Violet Mints

# 03200      Choward’s Lemon Mints

# 03500      Choward’s Spearmint Mints

# 03300      Choward’s Peppermint Mints

# 03000      Choward’s Scented Gum

Contact info: