Membership Sign up Form
Fields with asterisk (
*
) are mandatory.
Details
Please mark which job types you would like to receive Quote Request emails for:
Annual Reports
Forms - (Business/Carbonless/Continuous)
Art Prints
Greeting Cards
Banners/Signs
Invitations
Booklets
Labels
Books - (Hard Cover)
Letterhead/Stationery
Books - (Soft Cover/Paperback)
Magazines
Brochures/Pamphlets
Menus
Business Cards
Newsletters
Calendars
Newsprint - (Newspapers/Tabloids/Other)
Catalogs
Postcards/Mailers
CD or DVD - (Covers/Inserts/Jackets)
Posters
Copying/Duplicating
B&W Printing
Decals
Color Printing
Directories
Digital Printing
Door Hangers
Giclee Printing
Envelopes
Lithographic Printing
Flyers/Sell Sheets
Screen Printing
Folders - (Pocket/Presentation/Other)
Other
Which category of printer best describes you?
--Select a category--
Quick
Commercial
Digital
Screen Print
*
How long have you been in Business?
--Select an option--
Less than 1 year
1-4 years
4-8 years
More than 8 years
*
How did you find us?
Additional Comments
Contact Information
*
First Name
*
Last Name
*
Company Name
*
Position
*
Address (Please use the Address associated with your Credit Card)
*
City
*
State
--Select a state--
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
*
Zip/Postal Code
*
Phone
Fax
*
Email
Website
Membership
*
Membership Term
Every 2 Weeks : $46
Month to Month : $119
Quarterly (Every 13 Weeks) : $272
*
Select Payment Method
Credit Card
PayPal
*
Charge My...
VISA
Master Card
American Express
Discover
*
Credit Card #
(please do not use spaces or dashes)
*
Card Verification Number
(last set of digits on the back of your card)
*
Expiration
--Select a month--
January
February
March
April
May
June
July
August
September
October
November
December
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
*
Signature
(type in full name as it appears on credit card)
YES, I understand (and agree) that if I want to cancel my membership I will need to phone, fax, mail, or email my request to YourPrintRep. I also understand that membership rates may change over time, and that I will be notified at least 6 weeks (42 days) prior to any such rate changes.
YES, I agree to the terms in the YourPrintRep
Membership Agreement.
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