RetroPlate Concrete Sample Request Form

Curecrete provides the first 3 polished concrete samples FREE OF CHARGE. A $10 fees apply for each additional sample requested beyond the initial 3 plus shipping. Before beginning work on the samples requested, you will be contacted and provided with a quote. Should you agree to the cost of the additional samples, your payment information will be collected or confirmed at that time, and processed when the order has been completed and shipped out.

Before beginning work on the samples requested, you will be contacted and provided with a quote. Should you agree to the cost of the additional samples, your payment information will be collected or confirmed at that time, and processed when the order has been completed and shipped out.

Click on the links for more information:

Should you have questions regarding your request, please contact Brak Carman at [email protected].

Sample #1 (Free)
Colors #1
Aggregate Exposure #1
Finished Gloss #1
Sample #2 (Free)
Colors #2
Aggregate Exposure #2
Finished Gloss #2
Sample #3 (Free)
Colors #3
Aggregate Exposure #3
Finished Gloss #3
Additional Samples ($10 Each)
Please use the same designations as listed in the previous Color, Aggregate Exposure and Finish Gloss drop down fields.Feel free to only list the NAME COLOR, LETTER OF CLASS, and NUMBER OF FINISH GLOSS level.
Color Aggregate Exposure Finish Gloss
Customer Info
Name*
First Last
Company*
Shipping Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Billing Address is the same as Shipping Address?*
- Yes
- No
Billing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Special Note(s)
CAPTCHA

Color	Aggregate Exposure	Finish Gloss

Sample #1 (Free)

Sample #2 (Free)

Sample #3 (Free)

Additional Samples ($10 Each)

Customer Info