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Contact Information:
Name:	*
E-Mail:	*
Company:
Address:
City:
State/Province:
Postal Code:
Phone:	Fax:

Attribute Information:
Label Application
* (specify the use of the label)
Width	Height	# Across	# Colors
*	*		0 1 2 3 4 5 6 7 8

Material Type	Adhesive	Carrier Width	Vertical Repeat
Paper Polyester Kimdura Self Laminating Cloth Vinyl Polyolefin Polyethylene Tedlar Polyimide Tag Sleeves Static Dissapative Direct Thermal Drum Label Other *	Permanent Removable Freezer Void Tamper Indicating Ultra Aggressive Low tack Static Cling Anti Static All Temp Other *

Label Format	Perforations	Core ID	Roll O.D.
Roll Fanfold Pinfed Sheets *	No Yes	1" 1.5" 3" 4"	4" 5" 6" 8" 10" 12" 16" Other

Approvals	Print Method	Wind
UL CSA RoHS Military (MIL) (select multipe approvals by holding down the Ctr key)	Custom Laser Thermal Transfer Dot Matrix Ink Jet	In Out

Quantities to Quote (Price Per Thousand):
Quantity 1	Quantity 2	Quantity 3	Quantity 4	Quantity 5	Quantity 6
*
Quote Closest Die Also? Yes No
Blanket Order: Select one Yes No                 # Of Releases: Select one 1 2 3 4 5 6 7 8 9 10 11 12

Application Information:

1. Printer Mfg. And Model:

2. Dispensing Method: Hand Automatic

3. Describe Application:

4. Application Surface:

5. Application Temperature:

6. Service Temperature:

7. Expected Label Life:

Special Comments: