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This form must be attached to your purchase order.
All requested information must be provided for us to process your order.

PO must be made out to: WiLS, 728 State Street, Room 464, Madison WI 53706.

Contact Person:______________________________________________
 
Library:_____________________________________________________

Street:______________________________________________________

City, State, Zip:______________________________________________

Phone:________________________Fax:_________________________

Email: __________________________

Check one: ___ New Order ___Re-Order

Check one: ___ Order same label style/type ___Order different label style/type

Check one: ___ #5700 One-Part Label ___#5600 Two-Part Label

Imprint Line (35 characters max): ____________________________________

Starting Number: _______________________

Minimum order of 5000 labels required.

Type Finish (choose one):   Quantity
Price
None (#5700 $27.00/1000) (#5600 $42.00/1000) _______ _______
Varnish (#5700 $32.00/1000) (#5600 $42.00/1000) _______ _______
Gloss Laminate (#5700 $32.00/1000) (#5600 $42.00/1000) _______ _______
Matt Laminate (#5700 $32.00/1000) (#5600 $42.00/1000) _______ _______
Payment (choose one):      
___ Deduct from Deposit Account (no charge) Symbol __ __ __ ___   _______
___Please Invoice (service charge)   $10.00 _______
      Shipping   $10.00 _______
   
Total
_______