Section I - Client Information (*
required in BOLD )
Organization:
Billing Address:
State:
Please choose a state
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Connecticut
District Of Columbia
Delaware
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Vermont
Washington
Wisconsin
West Virginia
Wyoming
Armed Forces Americas
Armed Forces other
Armed Forces Pacific
American Samoa
Federated State Of Micronesia
Guam
Marshall Islands
Northern Mariana Islands
Palau
Virgin Islands
Zip:
Contact Name:
Phone Number:
Fax Number:
E-Mail:
Optional Numbers:
Section II - Document Information
Title of Document:
Source Lauguages:
Source Language 1:
select one
Other
French
English
Spanish
Portuguese
Italian
If other, please specify:
Target Language 1:
select one
Other
French
English
Spanish
Portuguese
Italian
If other, please specify:
Target Country 1:
Source Language 2:
select one
Other
French
English
Spanish
Portuguese
Italian
If other, please specify:
Target Language 2:
select one
Other
French
English
Spanish
Portuguese
Italian
If other, please specify:
Target Country 2:
Source Language 3:
select one
Other
French
English
Spanish
Portuguese
Italian
If other, please specify:
Target Language 3:
select one
Other
French
English
Spanish
Portuguese
Italian
If other, please specify:
Target Country 3:
Source Language 4:
select one
Other
French
English
Spanish
Portuguese
Italian
If other, please specify:
Target Language 4:
select one
Other
French
English
Spanish
Portuguese
Italian
If other, please specify:
Target Country 4:
Source Language 5:
select one
Other
French
English
Spanish
Portuguese
Italian
If other, please specify:
Target Language 5:
select one
Other
French
English
Spanish
Portuguese
Italian
If other, please specify:
Target Country 5:
Target Audience Education Level:
select one
Elementary School
High School
College and higher
none
Total Source Word Count:
Total Source Page Count:
Computer Hardware Platform:
select one
PC
MAC
Word Processing Software:
select one
Word
WordPerfect
Other
Word Processing Software, If Other:
Word Processing Software Version:
Pagesetting/Graphics Software:
select one
QuarkXpress
PageMaker
FrameMaker
Other
Pagesetting/Graphics Software, If Other:
Pagesetting/Graphics Software Version:
Desired Due Date in Organization/Client's
office:
Delivery Method:
select one
E-Mail
Fax
FedEx
Mail
Courier
Items to be included:
select one
Hard Copy
Diskette
no items to be included
Other Specifications:
Based on the information provided in Section I, CCCS,
Inc. will prepare a cost and time estimate, and e-mail it or FAX
it to the contact person for approval and signature.