Order Form

NAME         _______________________________________
 
ADDRESS  _______________________________________
 
CITY __________________ STATE ________  ZIP ______ 
 
PHONE _______________  EMAIL  ___________________
 
Batting (Circle)    Poly                        Low                 High
 
                             Poly/Cotton             Low                 High
 
                            Cotton                       Low                  High
 
Backing (Circle)          Yes          No       
If Yes, please select either   Natural   or   White
 
Edge-to Edge quilting : Yes         No         
Custom quilting:             Yes         No 
Binding:                           Yes         No 
 
Please place your quilt in a protective plastic bag.
[Not for storage - just for shipping.]
This will keep it clean and dry during shipment.
 
I use US Postal Service for mailing.
I also insure your quilt for $200.
If you wish added insurance value, circle yes,
enter the amount and we will include the added insurance
cost in our billing. 
Yes    Amount $ _____     
 
Use this area for any special instructions,
quilting ideas/themes or comments:
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The Quilting House
1500 West Walker Street
Breckenridge, Texas 76424