Your full name

Your company name

Address 1

Address 2

City

State StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Zip Code

Phone Number

Fax

E-mail

How did you hear about us? How did you hear about us? DexOnline Internet Search Referral Repeat Customer Yellow Pages Other

What size of label do you need?

How many labels do you need?

How will your labels be finished? How will your labels be finished? Rolls Fan-folded Sheeted

How many labels per stack/roll?

Will there be perforations between the labels? Will there be perforations between the labels? Yes No

What is the core size? What is the core size? 1 1 ½ 3 Other

How many colors will be on your label? How many colors will be on your label? 1 2 3 4 5 or more

What kind of adhesive does your label require? What kind of adhesive does your label require? Permanent Removable Freezer temp Cold temp Special Other

Will your labels be laminated? Will your labels be laminated? No Yes

How will your labels be applied? How will your labels be applied? Hand Applied Machine Applied