FicheNet Imaging Solutions 110 West C Street Suite 2019 San Diego, CA 92101-3998 Ph: 619.326.0644 Fax 619.326.0647

Printable Questionnaire For a Electronic Image Page Printing Quote - BETA

On-Line Form

My Contact Information:
	Name	_____________________________________
	Company	_____________________________________
	Title	_____________________________________
	My companies web http://	_____________________________________
I Prefer to be Contacted By:
	Phone	ext ___________
	e-mail	____________________________________

Name of My Application or Job:

_________________________________

Electronic Image Page Printing

I have the following type of images that need printed:
	tif images
	pdf images
	Other Type of image:			_______________________________________
Print your images in Black/white, color or a mix?
	Black/white			Faster and most economical (color images look good as greyscale)
	Color			Slowest and the largest investment (select if greyscale isn't good enough)
	Mixed			Middle of the road and priced accordingly
Would you like any Bates numbering or annotations added to the images?
	Yes
	No
	Explain:
	___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________
What size of prints would you like:
	8.5 x 11
	11 x 17
How many sets of prints do you need?
	___________________
Approximately many images do you need printed (in one set)
	___________________

Delivery or Shipping:
	FicheNet Imaging Solutions Pick Up and Deliver
	Use my own Company Courier
	Ship with Fed Ex
	Ship with UPS
	Ship with USPS
	Overnight? Second Day? Special Hours? Other:
	_________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________

I Wish to Pay by: (all Invoices are Due Upon Receipt unless otherwise arranged)
	Purchase Order / Company Check
	PayPal
	Personal Check
	Cash
	Other:
	_________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________

Any Other Details Below:

Any Other Details Below:   _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________