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<title>beeper, pager, cellular, computer labels order form</title>
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<h1><font color="#990066" size="3" face="Humanst521 BT"><strong><font size="5" face="Humanst521 BT, Arial, Times, Verdana"><a title="" href="mailto:mail@labelgraphicsinc.com?subject=web%20request">mail@labelgraphicsinc.com</a>order
          form </font></strong></font></h1></div></td></tr></tbody></table>
<form method="post" name="request samples" action="cgi-bin/formmail.cgi"><input name="recipient" value="mail@labelgraphicsinc.com" type="hidden" />
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<td width="22%"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana">company
        name:</font></td>
<td width="12%"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana">contact:</font></td>
<td width="66%"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"></font></td></tr>
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<td width="22%"> <font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="company name" maxlength="30" size="10" type="text" /></font></td>
<td width="12%"> <font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="contact" maxlength="30" size="10" type="text" /></font></td>
<td width="66%"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"></font></td></tr>
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<td width="22%"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana">address:</font></td>
<td width="12%"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"></font></td>
<td width="66%"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"></font></td></tr>
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<td width="22%"> <font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="address" maxlength="30" size="10" type="text" /></font></td>
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<td width="66%"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"></font></td></tr>
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<td width="22%"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana">city:</font></td>
<td width="12%"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana">state:</font></td>
<td width="66%"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana">zip:</font></td></tr>
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<td width="22%"> <font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="city" maxlength="30" size="10" type="text" /></font></td>
<td width="12%"> <font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="state" maxlength="30" size="10" type="text" /></font></td>
<td width="66%"> <font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="zip" maxlength="30" size="10" type="text" /></font></td></tr>
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<td width="22%"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana">ph
        #</font></td>
<td width="12%"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana">fax
        #</font></td>
<td width="66%"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"></font></td></tr>
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<td width="22%"> <font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="ph #" maxlength="30" size="10" type="text" /></font></td>
<td width="12%"> <font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="fax #" maxlength="30" size="10" type="text" /></font></td>
<td width="66%"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"></font></td></tr>
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<td width="22%"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana">email:</font></td>
<td width="12%"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"></font></td>
<td width="66%"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"></font></td></tr>
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<td width="22%"> <font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="email" maxlength="30" size="10" type="text" /></font></td>
<td width="12%"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"></font></td>
<td width="66%"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"></font></td></tr></tbody></table>
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<td width="4%"><font color="#990066" size="2" face="Humanst521 BT, Arial, Times, Verdana"></font></td>
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<div align="center"><font color="#990066" size="2" face="Humanst521 BT, Arial, Times, Verdana">quantity</font></div></td>
<td width="16%">
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<p><font color="#990066" size="2" face="Humanst521 BT, Arial, Times, Verdana">item
            code</font></p></div></td>
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<div align="center"><font color="#990066" size="2" face="Humanst521 BT, Arial, Times, Verdana">label</font></div></td>
<td width="19%">
<div align="center"><font color="#990066" size="2" face="Humanst521 BT, Arial, Times, Verdana">label
          color</font></div></td>
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<div align="center"><font color="#990066" size="2" face="Humanst521 BT, Arial, Times, Verdana">ink
          color</font></div></td></tr>
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<td width="4%"><font color="#990066" size="2" face="Humanst521 BT, Arial, Times, Verdana">#1</font></td>
<td width="12%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="1 quantity" maxlength="20" size="5" type="text" /></font></div></td>
<td width="16%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="1 item" maxlength="20" size="5" type="text" /></font></div></td>
<td width="12%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="1 label" maxlength="20" size="5" type="text" /></font></div></td>
<td width="19%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="1 back color" maxlength="20" size="5" type="text" /></font></div></td>
<td width="37%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="1 ink" maxlength="20" size="5" type="text" /></font></div></td></tr>
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<td width="4%"><font color="#990066" size="2" face="Humanst521 BT, Arial, Times, Verdana">#2</font></td>
<td width="12%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="2 quantity" maxlength="20" size="5" type="text" /></font></div></td>
<td width="16%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="2 item" maxlength="20" size="5" type="text" /></font></div></td>
<td width="12%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="2 label" maxlength="20" size="5" type="text" /></font></div></td>
<td width="19%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="2 back color" maxlength="20" size="5" type="text" /></font></div></td>
<td width="37%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="2 ink" maxlength="20" size="5" type="text" /></font></div></td></tr>
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<td width="4%"><font color="#990066" size="2" face="Humanst521 BT, Arial, Times, Verdana">#3</font></td>
<td width="12%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="3 quantity" maxlength="20" size="5" type="text" /></font></div></td>
<td width="16%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="3 item" maxlength="20" size="5" type="text" /></font></div></td>
<td width="12%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="3 label" maxlength="20" size="5" type="text" /></font></div></td>
<td width="19%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="3 back color" maxlength="20" size="5" type="text" /></font></div></td>
<td width="37%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="3 ink" maxlength="20" size="5" type="text" /></font></div></td></tr>
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<td width="4%"><font color="#990066" size="2" face="Humanst521 BT, Arial, Times, Verdana">#4</font></td>
<td width="12%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="4 quantity" maxlength="20" size="5" type="text" /></font></div></td>
<td width="16%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="4 item" maxlength="20" size="5" type="text" /></font></div></td>
<td width="12%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="4 label" maxlength="20" size="5" type="text" /></font></div></td>
<td width="19%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="4 back color" maxlength="20" size="5" type="text" /></font></div></td>
<td width="37%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="4 ink" maxlength="20" size="5" type="text" /></font></div></td></tr>
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<td width="4%"><font color="#990066" size="2" face="Humanst521 BT, Arial, Times, Verdana">#5</font></td>
<td width="12%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="5 quantity" maxlength="20" size="5" type="text" /></font></div></td>
<td width="16%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="5 item" maxlength="20" size="5" type="text" /></font></div></td>
<td width="12%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="5 label" maxlength="20" size="5" type="text" /></font></div></td>
<td width="19%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="5 back color" maxlength="20" size="5" type="text" /></font></div></td>
<td width="37%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="5 ink" maxlength="20" size="5" type="text" /></font></div></td></tr>
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<td width="4%"><font color="#990066" size="2" face="Humanst521 BT, Arial, Times, Verdana">#6</font></td>
<td width="12%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="6 quantity" maxlength="20" size="5" type="text" /></font></div></td>
<td width="16%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="6 item" maxlength="20" size="5" type="text" /></font></div></td>
<td width="12%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="6 label" maxlength="20" size="5" type="text" /></font></div></td>
<td width="19%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="6 back color" maxlength="20" size="5" type="text" /></font></div></td>
<td width="37%">
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <input name="6 ink" maxlength="20" size="5" type="text" /></font></div></td></tr>
<tr>
<td colspan="6">
<div align="center"><font face="Humanst521 BT, Arial, Times, Verdana"> <font size="3"> <font color="#990066"> <input name="lexan" value="radiobutton" type="radio" />
          lexan <input name="domed" value="radiobutton" type="radio" />
          domed </font></font></font></div></td></tr>
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<td colspan="6"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana">comments:</font></td></tr>
<tr>
<td colspan="6"> <font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"> <textarea name="comments"></textarea></font> </td></tr>
<tr>
<td colspan="6">
<div align="center"><font color="#990066" size="2" face="Humanst521 BT, Arial, Times, Verdana"> <input name="Submit" value="submit" type="submit" /></font></div>
<div align="center"><font color="#990066" size="2" face="Humanst521 BT, Arial, Times, Verdana"> <input name="Submit2" value="clear form" type="reset" /></font></div>
<div align="center"></div>
<div align="center"></div>
<div align="center"></div></td></tr></tbody></table></form>
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<td>
<div align="center"><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana"><strong>artwork
        will be faxed or emailed for label order</strong></font></div></td></tr>
<tr>
<td>
<div align="center"><font color="#cccccc" size="3" face="Humanst521 BT, Arial, Times, Verdana"><font color="#990066"><strong>an
        invoice will be faxed with every order</strong></font></font></div></td></tr>
<tr>
<td>
<div align="center"><font color="#cccccc" size="3" face="Humanst521 BT, Arial, Times, Verdana"><font color="#000000"><strong>background
        colors </strong></font></font></div></td></tr>
<tr>
<td>
<div align="center"><font color="#cccccc" size="3" face="Humanst521 BT, Arial, Times, Verdana"><font color="#000000">clear
        vinyl, white vinyl, ivory vinyl, yellow vinyl, metallic gold vinyl, gold
        vinyl, orange vinyl, red vinyl, metallic fucshia vinyl, metallic purple
        vinyl, royal blue vinyl, metallic dark blue vinyl, green vinyl, metallic
        silver vinyl, metallic gunmetal grey vinyl, elephant grey vinyl, metallic
        dark charcoal grey vinyl, black vinyl, brown vinyl, shiny silver mylar,
        shiny gold mylar, brushed gold mylar, brushed silver mylar, silver polyester,
        clear static cling, clear ultra removable, clear void, white void, shiny
        silver void, matte silver void, white destructible vinyl, white water
        contact indicator</font></font></div></td></tr>
<tr>
<td>
<div align="center"><font color="#cccccc" size="3" face="Humanst521 BT, Arial, Times, Verdana"><font color="#000000"><strong>ink
        colors </strong></font></font></div></td></tr>
<tr>
<td>
<div align="center"><font color="#cccccc" size="3" face="Humanst521 BT, Arial, Times, Verdana"><font color="#000000">gold,
        silver, white, black, blue, red, orange, yellow, green, teal, purple,
        pink, fuchsia, rainbow, oilslick</font></font></div></td></tr>
<tr>
<td>
<div align="center"><font color="#cccccc" size="3" face="Humanst521 BT, Arial, Times, Verdana"><font color="#000000">additional
        colors available</font></font></div></td></tr></tbody></table>
<p>&nbsp;</p>
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<tbody>
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<td>
<div align="center">
<h2><font color="#990066" size="3" face="Humanst521 BT, Arial, Times, Verdana">[<a href="home.htm">home</a>]-[<a href="labels.htm">labels</a>]-[<a href="materials.htm">materials</a>]-[<a href="glossary.htm">glossary</a>]-[<a href="contact_us.htm">contact
          us</a>]-[<a href="freesamples.htm">free label samples</a>] </font></h2></div></td></tr></tbody></table>
<p>&nbsp;</p>
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<td width="13%">
<h3 align="center"><font color="#000000" size="2" face="Humanst521 BT, Arial, Times, Verdana">Label
        Graphics &bull; 11298 Roselynn Way &bull; Lake Worth, FL 33449</font></h3>
<h3 align="center"><font color="#000000" size="2" face="Humanst521 BT, Arial, Times, Verdana">800.652.2351
        &bull; 561.798.8180 &bull; fax 561.790.7721</font></h3></td></tr>
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<div align="center"><font face="Humanst521 BT, Arial, Times, Verdana"><img alt="" width="89" height="35" src="images/smallogo.gif" /></font></div></td></tr>
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<td height="25" width="13%">
<div align="center">
<h4><font color="#000000" size="1" face="Humanst521 BT, Arial, Times, Verdana"><em>&copy;
          copyright label graphics</em></font></h4></div></td></tr></tbody></table>
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