Vendor Marking Product Request Form 
for Universal Studios Applications

One form per PO number, please.
$25 Expedite Charge.

 

Shipping Information
 Ship To Name:

Contact Name:

Street Address:

Address Line 2:

City:          State:
Zip:      
Phone:   
Fax:     

Billing Information
 Check here if same as "ship to" information; enter only fields that are different than "ship to".
 Bill To Name:     

Contact Name: 

Street Address:

Address Line 2:

City:           State:
Zip:      
Phone: 
Fax:     

 
 Order Date: 
  Your PO #:  
  e-mail:       

Premier Barcode Systems
4770 Highland Way
Center Valley, PA 18034
Toll free customer Service:
888-700-8977
Fax: (610) 791-2606
$35.00 Minimum Order Charge

IN THE FIELDS BELOW ENTER THE DATA TO BE PRINTED ON THE LABELS/TAGS YOU ARE ORDERING
Select Label Types

Type of Label/Tag
for Universal
Vendor Marking		 UPC  # Universal
Studios
PO #		 Description
(25 characters max)

Color
(Case & Carton Labels Only)

 Pieces per
 Carton
(Case & Carton Labels Only)		 Total # 
of 
Cartons		 Size Retail Price Quantity 
To Be 
Printed		 Vendor Part Number (Optional)

To Be Printed on Label:

Ship From:

Street Address:

Address Line 2:

City:          State (Country):
Zip:      
Phone:   
Fax:     

Ship To:

Street Address:

Address Line 2:

City:          State (Country):
Zip:      
Phone:   
Fax:     

Please note any additional shipping instructions here: