Identification Badging Request Form

(PLEASE PRINT) ( * = REQUIRED FIELDS)

COMPANY INFORMATION

* DATE: ACCOUNT # 
* COMPANY NAME: 
ADDRESS: 
* PHONE #: FAX: 

EMPLOYEE INFORMATION & INFO TO APPEAR ON THE BADGE

* EMPLOYEE NAME: 
* EMPLOYEE TITLE: 
EMPLOYEE ID #:  
OTHER INFORMATION TO APPEAR ON THE BADGE (i.e.: Height, Weight, Social Security #, Location) :
 
 

PAYMENT INFORMATION & AUTHORIZATION TO PRODUCE THE BADGE

* PAID FOR BY:(     )   COMPANY (     )   INDIVIDUAL
* PO # or PAY TYPE: 

   
* AUTHORIZED REP. REQUESTING THIS SERVICE * TITLE

LOCATION AND HOURS AVAILABLE FOR OUR BADGING SERVICE

We are open from 8:30am to 4:30pm (no appointment necessary during normal business hours)

Special times are available upon request, call to schedule your appointment

map

WE ARE LOCATED AT:
2222 East McDowell Road
Phoenix, AZ 85006
Just East of the 51 Freeway on the North-West corner of 22nd Place & McDowell Road
(602) 266-2307     (S800) 664-7175
Fax: (602) 244-0343
E-mail: badging@al-cor.com
visit us at: www.al-cor.com