Full Account #: (as written on check) * Starting Check #: * Name (as you want on check): * Name (as you want on check): Address: * City: * State: (put abbrev.) * ZIP Code: * Phone #: DL #: DL #: Monogram / Woodcut: (enter the number) Lettering: Times New Roman 9pt Times New Roman 10pt Arial 9pt Arial 10pt Calligraphy Script Old English * Fonts Color: Blue Stripe Burgundy Marble Green Stripe Brown Marble Stars and Stripes Yellow Parchment Granite Gray Business Payroll Stub Blue None(Deposit Slips) Voucher Check Blue * Type Of Check & Quantity: Regular Wallet Style 160 Regular Duplicate 200 Personal Deposit Slips 100 Business Checks 150 Business Checks 300 Business Checks 501 Bus Dep Slips 201 3/page Bus Dep Slips 200 4/page Voucher Checks 1/page Voucher Checks 3/page Bus. Dup. 4/page Dep Slips * Cover: None Black Blue Burgandy Green Mail or Pickup: Pick-Up Main Branch Pick-Up Mall Branch Pick-Up Kokomo Pick-Up Delphi Branch Mail - There will be a charge for postage * Confirmation: YES Please enter a valid e-mail: * By checking the box to the left, I am certifying that the above information is what I wish to be printed on my checks. If I request order to be reprinted, I will be charged for both orders, unless above information is not what is printed on my checks.