form

ORDER FORM

Use the Print feature on your browser to print this form and mail with your payment.
Please write in which quilt top you are ordering (Quilt 1, etc.)
Quilt Tops are $50 each.

NAME:

ADDRESS:


PHONE NUMBER:

QUANTITY         QUILT NUMBER            PRICE                     TOTAL
_______________________________________________________

_______________________________________________________

_______________________________________________________

_______________________________________________________

                                                      SUBTOTAL __________________

                                                      SHIPPING                      $15.00

                                                       TOTAL        _________________

MAIL YOUR ORDER AND PAYMENT TO:

LINDA WALKER
PO BOX 487
POLLOCK, LA 71467

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