Sample Request

Your Contact Information

All fields marked * are required

First Name *

Last Name *

Job Title *

Company Name *

Email Address *

Phone Number *

Company Website (optional)

Company Profile

Helps us confirm the Cygnus 360 is the right fit for your team

Primary Industry *

Workers Requiring Hard Hats *

Estimated Annual Hard Hat Purchases *

Current Hard Hat Brand / Supplier (optional)

Do workers currently use any lighting on their hard hats? *

Yes — all workers Yes — some workers No Not sure

Sample Request Details

One sample unit per request

Color Preference *

Black

Model 360H-BK

White

Model 360H-WH

I am evaluating the Cygnus 360 for: *

Company or fleet purchase

Equipping my workers

Distributor or resale

Adding to my product catalog or distribution network

Government or contract bid

Evaluating for a specific contract or procurement process

Personal use

For my own use on the job

Expected Purchase / Decision Timeline *

Shipping Address

Where should we send the sample unit?

Attention To (if different from your name above)

Street Address *

Suite / Unit / Building (optional)

City *

State *

ZIP Code *

A Few More Details

Optional — helps us prepare for the right follow-up

How did you hear about Cygnus? (optional)

Referred by / Event Name (optional)

Anything else we should know? (optional)

Sample Program Terms

Sample units are provided for product evaluation purposes only. Cygnus Safety Products reserves the right to approve or decline sample requests at its discretion. We ask that recipients provide honest product feedback within 30 days of receipt.

By submitting this form you agree to be contacted by Cygnus Safety Products regarding your sample request and follow-up questions. We do not sell or share your information with third parties.

I agree to the sample program terms and understand that Cygnus will follow up regarding my request. *

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