Print Sample Request Form CIJ and Laser

Please complete the following fields to request a print sample on your substrate. The more details provided, the better. Required fields are marked with an asterisk. Please include 10 – 15 substrates to allow for ink testing, setup, and print sample runs.

Send CIJ and Laser samples to:

Squid Ink

Attn: Eric Bezanson

7041 Boone Ave. N.

Brooklyn Park, MN 55428

Distributor Company Name

Distributor Sales Rep Name

Distributor Sales Rep Email

Squid Ink District Sales Manager

Returns Samples to

Account # (if Expedited Shipping is being requested)

Ship to Address to Return Samples

End User Company Name

End User Company Address

End User Contact Name

End User Company City

End User Contact Phone

End User Company State

End User Contact Email

End User Company Zip Code

Type of Printer Desired

CIJ

Laser

CIJ Nozzle Size

Print Location on Product

Substrate Description

Substrate Temperature (In °F)

Product Environment

Clean	Condensation
Dry	Dusty
Frozen	High Humidity
Retort	Washdown/Wet

Code Durability/Performance Conditions

Abrasion	Refrigerated/Frozen
Scratch Test	Sunlight/UV Fading
Tape Test

Environment Temperature (In °F)

Line Speed (In FPM)

How much time before code is touched (Minutes)

How much time before code is touched (Seconds)

Ink Number Requested (add ink number or description)

Message to be Printed

Message to be Printed (attach image)

Multiple Attachments?

Select the box to add more attachments

Other Attachments

Message to be Printed (attach image 2)

Message to be Printed (attach image 3)

Message to be Printed (attach image 4)

Message to be Printed (attach image 5)

Message to be Printed (attach image 6)

Message to be Printed (attach image 7)

For Laser Print Sample Requests Only

Type

DynamicStationary Marking

Cycle Time While Stopped (in seconds)

Exact Message Format:

Specific Fonts Requested

Font Size(s) (in mm)

Specific Layout (line spacing, character spacing, number of print lines)

Comments

Enter your email address to receive a copy

Inbound sample tracking number

Please print the electronic copy sent to your email and place it in the box when shipping samples to Squid Ink.

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