ADT Enterprises, Inc.
Please fill out form, print, and fax to 816-767-0514.
    
Contact Name
Primary Customer Name
Secondary CustomerName

Bill to Address
City State
Zip Code

Ship to Address
City State
Zip Code

Telephone
FAX
E-mail

Products

Labels    Pro Books   ID Cards   Scanning Equipment
(Not all fields apply to all products)      

Please mail camera ready art work for pro books and ID cards.

Please list questions about ordering scanning equipment in comments box.

1. Type of label

2. Size of Label

3. Laminate

4. Bar code symbology (format)

     If codabar please enter start and stop characters. Start  Stop


5. Institution's name as it should appear above the bar code.
     (limited to 35 characters for 2" labels or 27 characters for 1.6" labels)

6. Is a check digit required? Yes No
     (If check digit is required please provide actual barcode labels that you currently use.)

7. Total number of digits in barcode (including check digit if needed)

8. START NUMBER (Put an X for check digit)

9. STOP NUMBER  (Put an X for check digit)

10. Shipping Options  

Comments

If you have a sample label please affix here.