* MANDATORY FIELDS

* First Name:


* Last Name:


* Email Address:


* Voice Phone Number:


* Shipping Address (Complete Street Address Required):


* University Index Number (Department Account Number):
- This must be a 6 digit numeric – no more, no less

* IRB Number (Internal Revenue Bill):
I – This must be a 6 digit numeric – no more, no less

* Job Name:

*Date Stock Due to Technicom:

*Date Database Due to Technicom:

* Mail/Completion Date:

* Quantity:

* Must check one of the options below:
Delivery to Post Office
Other
Description:

* Must check one of four options below:
Non Profit (Bulk)
First Class
First Class Presort
Other
Description:

* Components/Material Description - List All:
(Self mailer, #10 Envelope, Etc.)

Check all that apply:

Offset Printing:

Data Processing Operations:
Key Enter Mailing List
Read in Disk
Read in Email
Eliminate Duplicates In Only One File
Merge Two or More Files, Eliminating Duplicates
Merge Two or More Files Without Eliminating Duplicates

Eliminate Duplicates by This Criteria:
Select One Exact Match (First name, Last name & Address) Last name & Address One Per Address

Output (Other Than Inkjet):
Avery Laser Labels
Laser Letter
Laser Envelopes
Other


Machine Operations:
Inkjet (Spray Address Directly Onto Mailing Piece)
Inkjet Mailing Permit
Tab Seal
Insert Pieces into Envelopes
Fold Pieces to Mailing Size
Other

Hand Insert Pieces
Hand Match Two or more Inserts
Pressure Sensitive labels (peel & stick on pin feed paper)
Avery Laser Labels
Other

Please describe this job and include miscellaneous notes:


Technicom Driver to pickup Materials: (enter date, address, contact name & number)


Return balance of materials to: (Enter address, contact name & number)