*Description of Item(s) Needed

 

Item Number(s), if available

 

*Please indicate one:

  New Order
Reorder
Reorder with Changes

If this is an item you have ordered from us in the past, do you have the invoice number from your previous order?


 

If yes, please list it here:

 

*Quantity/Quantities to Quote

 

Details (If this is a reorder that will require changes, please list the changes here. If this is a new item, please provide as much detail as you can.)

 

*Your Name


 

*Company Name (if this product is for you personally, then please put your name here)


 

*Street Address


 

Suite/Apt #/Dept #


 

*City


 

*States or Province


 

Other


 

*Zip


 

*Phone


 

*Fax


 

*Email


 

*Please indicate how you would like to have us contact you with your quote or with any questions:

  Email
Fax
Phone

3518 SE 21st Street, Suite B, Topeka, KS 66607 |  (p) 800.264.0068 or 785.232.3606  |  printing@kalos-inc.com

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