Label Quote Request Form
*=Required Field
Customer's Contact Name
*
First and Last
Date
*
-
Month
-
Day
Year
Auto-fills Today's Date
Customer Company Name
*
Must Use Full Customer Name
HRTLP Sales Rep Email Address
*
example@example.com, copy of request will be sent to this email
Phone number
*
Heartland Sales Rep Name
First Last
Heartland Account Number
If Known
Company Address (New customers only)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Printer Make and Model
Label Specifications
Height, width, amount
Horizontal Label Width
*
In inches
Vertical Label Width (Height)
*
In inches
Is the label linerless?
*
Yes
No
Auto Applied
Yes
No
Is the liner perforated?
Yes
No
Does the label have perforations or slits?
Yes
No
Slits (all that apply)
*
Back Slit Vertical
Back Slit Horizontal
Notch Timing Indicator
Black Bar Timing indicator
None of the above
Face Slit Vertical
Face Slit Horizontal
Stock
*
Coated Thermal Transfer
Direct Thermal (High Speed)
Direct Thermal (Regular Top Coated)
Direct Thermal (Non-Topcoated)
Direct Thermal - RX
DT Film
TT Film
Other
Type of Adhesive
*
Permanent
Cold Temp
Removable
Other
Description of Other
Substrate
*
Corrugated
Plastic
Other
Printing Instructions
Color, ink, Photo upload
Printed?
*
Yes
No
Number of Colors
Number of Colors appearing on label
Black Timing Mark?
Yes
No
Upload Photo or Information
Browse Files
Drag and drop files here
Choose a file
Must be a jpg, png, or pdf
Cancel
of
Product Specifications
Roll type, quantity
Product Type
*
Please Select
Rolls
Fanfold
Rolls or Fanfold
Labels per roll
Rolls per case
Roll OD
inches
Core ID
inches
Labels per fold
Stacks per case
Labels per stack
Shipment
Quantity for Quote, Address for delivery
Order Quantity - In Thousands of Labels
*
In thousands of labels
Order Frequency
*
Please Select
One Time Order
Weekly
Monthly
Quarterly
Annually
Other
Other - Frequency
*
Margin Percentage
*
FOB Location
*
FOB Little Chute, WI
FOB Rancho Cucamunga, CA
FOB Windham, ME
Other
Zipcode
Special Packaging Instructions or Other Information
e.g. Poly bag, shrink wrap, box in box, etc.
Opportunity Number
*
Submit
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