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Our objective is to provide our customers with appropriate solutions to their label/printing needs in a timely manner at the best price available.

Your Name:

 Date:  MM/DD/YY
Company Name:
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Address:

Sales Rep: 

(If known)
City:
Phone:
State:
Fax:
Zip:
 
Email address:

Please provide answers to the following (if applicable).  If you are unsure of any of the questions, indicate "Not Sure" or leave the area blank and a media specialist will discuss it with you.

Your Printer Make And Model:

Label /Tag

Size:

 

Width            

Height         

Thickness 

Printer Type:

Adhesive:

Label Type:

Number Across:

Sensing:

Material Type:

Print Mode:

    

Printing:

4 Color Process:

# of Colors

       

  Front           Back

PMS Colors:

List all - use comma separator

  

Perforation:

  Perforated  Not  Perforated

Wound Direction:

Core Size:

 3"  1"  Other

 Outer Roll Diameter:

  4"  5"    6"

  8"  10"  12"

Label Lifespan:

  < 6 Months  > 6 Months

Temperature after Application:
   

Temperature during Application:

Special:

Need drawing or sample

Resistance:

Ex: chemical, moisture, grease, alcohol, abrasion, high temperature

Wound Out

  LR01

  LR02

 

  LR03

  LR04

  

Wound In

  LRI1

  LRI2

 

  LRI3

  LRI4

 

Label Quantity

to Quote:

 

Ribbon:

Ribbon Quantity

to Quote:

Additional Application Information, Comments or Questions:

   

          

 

 

  
 

 

      
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