Custom Bar Code Label Order Form

Please complete the form below or download our Premium Bar Code Label Form.
Upon completing the form you may return to us via email at barcodes@vernlib.com or fax to 800.466.1165.
You can also contact us to fax or email you this form if you are unable to download large files.
A Vernon bar code specialist will contact you as soon as possible to help you complete your purchase.

Customer Number (if known):
Name:
Institution Name:
Title:
Phone:
Fax:
Mailing Address:


City:
State:
Zip:
Residence or Business:
Delivery Address: (if different)

City:
State:
Zip:
Residence or Business:
Email:

Item/SKU number:
Quantity:
Heading above the bar code:
(maximum 27 characters for 1.6" wide bar codes)
(maximum 35 characters for 2.0" wide bar codes)
Bar code symbology (if known)
Bar code will be used for (items/patrons):
Total number of digits (including check digit if needed):
Start number (please include entire number):
Stop number (please include entire number):

If possible, please fax (1.800.466.1165) or mail us samples of your existing bar codes. Feel free to call us (1.800.878.0253) for assistance in filling out this form.

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