Web Site Name * Surname * Email * Phone Number * Company Name * Street Address * City * Province * The Eastern Cape The Free State Gauteng KwaZulu-Nata Limpopo Mpumalanga The Northern Cape North West Western Cape Zip Code * Quantity * Label Width * Label Height * Perforated? * Yes No Label Material * Semi Gloss Thermal Top Coated Thermal Econo White Polypropylene Clear Polypropylene Silver Polypropylene Tyvek Polyester Dayglo Tag Material Other Adhesive Type * Permanent Hot Melt Permanent Acrylic Removable High Tac Cold Temperature Pharmacy Solvent Other Specify (If other) * Substrate Conditions Flat Curved N/A Temperature to be supplied at: * Type of container applied to: * Substrate Texture * Rough Smooth Dry Moist Painted Unpainted Clean Contaminated Is this being used in a printer * Yes No How is the Label Applied? * Machine Applied Hand Applied Full Colour * Yes No Number of Spot Colour/s * Artwork * Label Details/ Comments *