Contact Person
Company Name
Company Address
Telephone Number
Fax Number
E-mail Address
Number of Pieces Document SizeX
Inserts:Yes No Folded:Yes No Folded sizex
Number of Inserts: Number to Fold:
Labels Supplied: Disk containing names and addresses List Rental
Pressure Sensitive Labels in zip order Cheshire Labels
Pressure Sensitive Labels in random order
Other Explain:
Class of Mail: First Class Standard
Periodical Other:
Please identify the mailing below:
Local/Statewide For Profit Organization Permit Stamps
Nationwide Non-profit Organization Meter
Any additional mailing information
Area: Zip Code:
Town:
Streets:
Other:
Criteria: Income:
Businesses:
Homeowners/Renters:
Quantity to Print: Size:x
One sided Two-sides
Paper: Color: Weight:lbs
Ink: Color:1) 2)
3) 4)
Typesetting: Yes No
Graphics Supplied: Yes No
Please give brief explanation of the job to be printed below
150 Forrest Ave. Springfield, IL 62702 Phone: 217.522.2780 Fax: 217.522.2883 Toll Free: 800.766.2451
E-mail: RKamerad@modernmailingservices.com