#### Customer

Customer Name:
Please Provide a Customer Name.
Customer ID:
Please Provide a Customer ID.
In QB?:
QB Order Number:

#### Staff Fields

Order Num:
Order Date:
Please Provide an Order Date.
Proof Date:
Ship Date:
Ship Via:
Quantity:
Please Provide a Valid Quantity.
Price:
Please Provide a Valid Price.
Invoice To:
Please Provide an Invoice Address.
Ship To:
Please Provide a Ship To Address.
PO Number:
QB Item:
Please Provide a QB Item.
Job Name:
Please Provide a Job Name.
Item Description:
Art Due:
Plate Due:

#### Supplied by Customer

B/W or Color Copy:
Plates:
Sample:
Dimensional Layout:
Other:
Email:
FTP:
Total Inches Used:
Sheets Used:
Initials:

#### Proofing

PDF?
PDF To:
PDF Date 1:
PDF Date 2:
PDF Date 3:
Full Size Ink Jet For Layout Content Only?
Ink Jet To:
Ink Jet To 2:
Ink Jet Date 1:
Ink Jet Date 2:
Ink Jet Date 3:
Color Contract:
Color Contract To:
Color Contract Date 1:
Color Contract Date 2:
Digital Color Key:
Digital Color To:
Digital Color Date:

#### Quantity

Press Name:
Anilax Info:

#### Colors

#### Plate Marks

Microdots:
Microdots Comments:
Crosshairs:
Crosshairs Comments:
Color Bars:
Color Bars Comments:
Other:
Microdots Comments:

#### Layout

Around:
Accross:
Surface Print:
Reverse Print:
Cylinder Repeat:
Cutoff Dimension:
Pitch:
Teeth:
Bleed:
Cutback:
Minimum Trap Dimension:
Maximum Trap Dimension:

#### Print Orientation

Print Orientation:

#### UPC

Size:
Bar Width Reduction:
Distortion Percent:
Distortion Amount:

#### Plates

Thickness:
Plate Material:
Job Number:

#### General

Comments