COLLATE Yes No STAPLE Yes No
FOLD Single Letter *Per Sample
CUT Yes Size PAD Top Side
DRILL 3 Hole 2 Hole Side Top
BOOKLET Yes No
MATERIALS
Printing Plates @ ________________________ = ________________________
Press Impressions @ _________________________ =_________________________
C0LOR Impressions @________________________ =_________________________
COPIER Impressions
@_________________________
=_________________________
Envelope Impressions @_________________________ =_________________________
White Paper @________________________ =_________________________
Glossy Paper @________________________ =_________________________
Colored Paper @_________________________ =_________________________
Cover Stock Paper @_________________________ =_________________________
Special Order/Mis. @ ________________________ = ________________________
NCR @ ________________________ = _________________________
Envelopes @ ________________________ = _________________________
Art Work @ ________________________ = _________________________
Binding/ @ ________________________ = _________________________
TOTAL ________________________
* Overhead _______________________
FOR PRINTING SERVICES USE ONLY
LABOR (in minutes)
Duplicating Labor _____________________min @_________________________ = TOTAL LABOR ______________
DATE OF REQUEST DATE REQUIRED REQUESTER REQUESTER PHONE #
TITLE OF WORK
CHARGE TO :
DELIVER TO:
STATUS OF MATERIALS SECURITY
Shrink Wrap
REQUIRED?
NUMBER OF NUMBER OF
*ADDITIONAL REMARKS
ORIGINALS COPIES
COPY READY
COMPOSITION / DESIGN
NEEDED
Yes
No
INK COLOR (Color PRESS Work Only)
Full Color Ink (CMYK)
*Other *(Specify) __________________
PS REQUEST FORM Rev. September 2020
TOTAL COST ____________________
PRINTING B&W COLOR (PRINT)
1 Side Head to Head
Back to Back Head to Foot
NUMBER OF IMPRESSIONS ______________
PAPER SIZE TYPE COLOR NCR
PRESS ONLY
PRINT SERVICES REQUEST FORM
USE OF PRINT SERVICES:* A minimum of 24 hours is required for any work submitted. For specic times, please contact staff 209-384-6265.
A valid account number (Designated below by department) and proper authorization is required of all work submitted. When submitting a print request, the department will
assume that proper authorization to utilize our services has been granted. The requester assumes responsibility for any charges due where permission has not been given.
BY SUBMITTING THIS FORM YOU AGREE TO THE TERMS OUTLINED BELOW:
The requestor assumes full liability for any work submitted. Any customer requesting, or using, copyrighted work for purposes in excess of “fair use with proper
permission” is liable for copyright infringement and is subject to civil and criminal penalties. We reserve the right to refuse a print request if, in our judgment, fulllment
would involve any violation of copyright law. In such circumstances, an authorizing ofcial’s permission will be required before proceeding with the print request.
Have any problems with this order? Any concerns or suggestions?
Need a service not listed or have special requirements?
Please contact the Print Services Supervisor at 384-6179
or richard.manifest@mccd.edu
Our Success is Measured by Your Satisfaction!
Print Services Stop 41
CURRENT VERSION Rev. Sept. 2020
Please SAVE this form and send it as an attachment to: Print_Services@mccd.edu
