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1. Do you print on carbonless sheets? Yes No
(If yes, please continue. If no, please disregard.)

2. How many cartons of carbonless sheets do you purchase per month? (choose one)


Less than 1	1 to 8 cartons	9 to 16 cartons
17 to 24 cartons	25 or more cartons	Don't know

3. What percent of your total carbonless sheet purchases are from the following manufacturers?(should total 100%)


Appleton/NCR PAPER*/Superior	%	Mead/Glatfelter/Excel	%
Imation/Nekoosa/U20	%	Xerox	%
Other Brand	%	Please Specify Other Brand

4. Which of the following types of equipment do you have? (check all that apply)
(examples of toner-based digital are high-speed copiers/production units, laser printers)

Offset	Digital Duplicator/RISO
Black & White Toner-Based Digital	Inkjet
Color Toner-Based Digital	Other – Please Specify:

5. If you produce carbonless forms on this equipment, indicate the percentage of your total carbonless forms volume on each: (Should total 100%)


Offset	%	Digital Duplicator/RISO	%
Black & White Toner-Based Digital	%	Inkjet	%
Color Toner-Based Digital	%	Other Brand	%
		Please Specify Other Brand

Primary Carbonless Supplier?

Merchant/Store Name:	If Other Please Specify
City:
State/Province:

YES! Please continue to e-mail me Team Appleton offers, information and promotions.

No, thank you. Please do not contact me by e-mail.

Company Type(choose one):

Business In-Plant (Business that runs its own print shop)

Government/Tax Supported/Educational/Not for Profit

Copy Shop Only (Walk-in business, but no sheet-fed presses)

Quick Printer (Walk-in business, sheet-fed presses)

Commercial Printer (Outside sales reps, carries credit, independent sales agents)

Other (Specify) -

First Name:
Last Name:
Job Function:
Company Name:
Company Physical Address (No P.O. Boxes):
Department/Mail Stop:
Suite/Unit/Apt:
Country:	USA Canada
City:
State/Province:
ZIP/Postal Code:	-
Same As Shipping/Physical Address
Company Mailing Address:
Suite/Unit/Apt:
Country:	USA Canada
City:
State/Province:
ZIP/Postal Code:	-
Phone:
E-mail Address:

*Verification Code: