T-Shirt Quilt Order Form

Name *

Street Address **

City

State

Zip Code

Choose One: *

Return shipping: Would you like to have to sign for the box?*

Phone Number

E-Mail address *

Desired Quilt Size: *

Backing Color: *

Binding Color:*

Optional Border: Choose one if desired)

Color or colors for border: *

Other Products:

Time Frame (Choose one) *

Who is the quilt for?*

Is the quilt a surprise?*

If so, can we contact you via E-mail?

Do you have a code word we can use if we need to call you?

May we use a photograph of your quilt on our web site?*

Where did you hear about us?*

Who referred you to us?

There are 3 methods of payment:*

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