Replacement Labels Form
Name
*
First Name
Last Name
Business Name
*
E-mail
*
example@example.com
Contact Number
*
Label Type:
Choose your kiosk model
*
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( X )
Kiosk with Built-in AE Printer
8 Packs of 1000 Labels (Total: 8000)
$
125.00
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
Kiosk with external Brother QL800 Printer
10 Rolls of 320 Labels (Total: 3,200 )
$
75.00
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
Shipping Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Payment Option:
*
Request Invoice
Credit Card
Payment Details
*
Cardholder Name
Card Number
MM/YY
CVV
Submit
Should be Empty: