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* Name
* Email
* Company
* Phone
Fax
Address
City	State     Zip

* Required Fields

Quantity 1	Quantity 2	Quantity 3
I will provide the job on the following media:
Mac Disk	PC Disk	Film

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Size Flat	Bleeds    Number of Pages
Paper Brand	Cover    or Text
Color	Weight    Finish

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Percent of Ink Coverage

Number of Colors:  Side 1    Side 2

Varnish    or Aq. Coating

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Perf	Score	Number	Flat Foil
Comb Foil	Emboss	Glue / Fold	Fold
Saddle Bind	Die Cut
Special Press Instructions