Pacific Northwest Barcode Services
Building Custom Barcode Masters for Books and Products

Custom BARCODE Order Worksheet
Instructions:  
  1- Print this page.
2- Using BLACK ink, fill in BARCODE data on ISBN, Selling Price, and Title.
3- Select delivery options and calculate total price of order.
4- Provide payment information for credit card or check.
5- Provide eMail or shipping address.
6- Credit Card Orders FAX TOLL FREE 24/7 to 888-254-4535 for immediate processing.
PRICING: 		 
  Custom Built Barcode
$30.00
  Add:  
 
 Camera Ready Laser Printing
$10.00
 
 First Class Postal Mail
N/C
 
 PRIORITY Mail
$15.00
  EXPRESS Mail
$25.00
 

TOTAL 

 $_______
DELIVERY: All barcodes are delivered by email unless laser printed
Camera ready copy is ordered, which is delivered by
First Class Postal Mail at no extra charge!
Place your order in three easy steps:
  1- Print this Work Sheet,
  2- Add your data,
  3- FAX or Mail
BARCODE DATA
 ISBN of book:  Selling Price:$
 TITLE of book:
  • Payment must be made with order.
  • Provide your Credit Card data below and send this form by FAX TOLL FREE to 888-254-4535.
 P a y m e n t   I n f o r m a t i o n
Order Placed by:
Visa/MasterCard Number:
Cardholder Name:
Card Account Street Address:
Name: Title: Tel:
Expiration Date: /
Month Year
CSC#
(on back)
 Telephone:
x
Card Account City, State, Zip: City

State

 Zip
Email Adress:
NOTICE: Your signatue indicates that you have read and agree with our TERMS & CONDITIONS.
 
Please sign here
Date
Questions? Call us at 1-866-530-1656, Monday through Friday 9:30am-3:00pm Pacific Time.