Media Supplies Application Survey
Fill the fields below accurately and we will return back to you in a short time
Company Name
*
Company Name
E-Mail
*
Email
Contact Person
*
First Name
Last Name
Office Phone Number
Format: (000) 000-0000.
Cell Phone Number
*
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Application Information
How will your company or your customer be using bar code labeling technology?
Business Description
Estimated annual volume of labels/tags?
Printer (Brand/Model)?
What type of printer(s) will be used with these labels/tags?
Print Method
Batch
Self Strip
Scanner
Visible Light
Infrared
Specifications
Material to be labeled
Paper
Corrugated
Plastic
Glass
Wood
Metal
Other
Material (If "other" was selected)
Surface Conditions
Dry
Wet
Clean
Contaminated
Rough
Smooth
Flat
Flexible
Cold
Oily
Other
Surface Con. (If "other" was selected)
Smart Label Type
Thermal Transfer
Direct Thermal
Label
Tag
Other
Smart Label (If "other" was selected)
Dimensions Height
Dimensions Length
Perforations
Between labels
Facestock
Liner
None
Slits
Face
Liner
None
Printing
Face
Liner
None
If printed, how many colors
1
2
3
4
Facestock
Smear-resistant
Abrasion-resistant
Solvent-resistant
Tear-resistant
Humid/Wet
Other
Facestock (If "other" was selected)
Adhesive
Permanent
Removable
High Tack
Cold Temp
Other
Adhesive (If "other" was selected)
Label Life: Months
Label Life: Years
Environmental Conditions
Rows
Select all that apply
Temperature Range _____ F/C to _____ F/C
Storage
Application
Processing
End Use
Indoors / Outdoors
Indoors
Outdoors
UL Requirement
Yes
No
Will an applicator be used?
Yes
No
If YES, what Brand & Model?
Additional comments and considerations for this project: possible)
(Please be as thorough as possible)
Please verify that you are human
*
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