Creative Quilts - Childhood Memory Quilt Order Form

Please fill out the form as completely as possible. If an item doesn't seem applicable, leave it blank.
Remember that you will be printing and mailing this form. If you must scroll to read anything typed in one or more of the input boxes below, your information will not all print out! If you need to type more than will fit in a box, please type or write that information legibly on a separate sheet of paper.
Click the "Calculate Payment" button at the bottom of the form to have your total payment calculated for you. Please be sure you have selected all options you would like to add to your quilt, as well as your preferred shipping method.
Print the completed form and mail with your materials to be used in the quilt and your payment (if paying by check or money order) to:

Creative Quilts
758 Commanche Drive
Jefferson City, Tennessee 37760

ORDER INFORMATION

Size & price
If the size you would like is not included above, please contact me for pricing.

If other, please specify

Specific information you would like machine embroidered into the quilt (optional)
For example, child's name, birthdate, time of birth, birth weight, place of birth, baptism date, name of church, etc.
$21.75 per line, maximum of 21 characters per line

lines x $21.75

Please enter information below exactly as you would like it to be embroidered:

Please specify color of embroidery

Add hanging sleeve - $15.00 (optional)

Add label to back of quilt - $15.00 (optional)

What would you like the label to say?

Fabric colors you wish used

How much will this quilt be used?

List the items you're sending:

List any items that should not be cut:

Is there a specific time that you need to have the quilt completed?

SHIPPING/CONTACT INFORMATION

Name

Address Line 1

Address Line 2

City, State

Zip Code

Phone

E-mail

Please specify the shipping option you prefer.
Your quilt will be returned to you in an airtight plastic bag inside a box to protect against moisture.

FedEx Ground - $20.00
FedEx 2 Day Express - $40.00

PAYMENT INFORMATION

Please indicate your method of payment:

Card # - - -
Expiration date
Name of cardholder

Tennessee residents, check here to add 9.25% sales tax.

Total payment

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Web site graphics by Chibi Creations.