Your Name: Company: Address: City: State/Province: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming ------------------ Other ------------------ ,     Zip/Postal Code: Phone:           ( )       FAX: ( ) E-mail:             How did you find our Website?   (Example: Yahoo, Google, Excite, Lycos, etc. . . . Referral, etc.) LABEL SIZE: Width:   x   Length:     inches mm Label Shape:   (select one) -------------- Square Corners Rounded Corners Circle Oval Special Shape (*) No Shape   (*) If special shape, describe: Format:   (select one) -------------- Individual Pieces (1) Strips (1) Sheets (1) Rolls (1), (2) Fanfolded (1)   (1) How many Labels per package/rolls:   (2) If in Rolls, what is desired Outside Diameter: Total Quantity:   Cutting Method:   (select one) -------------- Die cut Kiss cut Butt cut Guillotine Laser cut Face score Sheeted Thermal die cut Sheared No cutting Not sure   (if applicable -- select another) -------------- Not Applicable -------------- Die cut Kiss cut Butt cut Guillotine Laser cut Face score Sheeted Thermal die cut Sheared No cutting Not sure MATERIAL: Base Material (that Label will be PRINTED on):   (select one) -------------------- Paper Vinyl Polyolefin Polyester Polycarbonate (Lexan) Other (1)   (1) If "Other", please describe here:   Adhesive Lamination (if any):   Permanent   Removable   None Top Lamination (if any):   Clear   Matte   Special   None COLORS: Number of Colors SPECIAL INSTRUCTIONS: Write out any other special instructions or information you think we may need:

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