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Company Name
First Name
Last Name
Address Line 1
Address Line 2
City
State
Zip Code
Daytime Phone	() -
Fax	() -
E-mail Address
Name of Product (brochure, business card, etc.)
Quantity 1
Quantity 2
Quantity 3
Paper Dimensions—FLAT
Finished Size—FOLDED
Weight and Type of Paper
Full Color (CMYK) Inks?
When will this item be needed?
Anything else you want us to know?