Address___________________________________________________________

City______________________ State_________________________ Zip_____

Telephone (____)_________________day (_____)_________________eve

Name of Quilt ____________________________________________________

Dimensions _________ inches x __________ inches

Brief description of quilt to be used in the show booklet.___________________

__________________________________________________________________

__________________________________________________________________
Please check the category which best describes your quilt (choose only one category --- We reserve the right to change the category if we feel the quilt is incorrectly entered):

____ Pieced	____ Applique	____ Group	____ Other Techniques
____ Miniature	____ Wall Hanging	____ Theme

Estimated value of Quilt $____________________
(This is essential information for insurance purposes only. Any quilt valued at over $500.00 must show proof of value, such as an Appraisers Report. Your quilt will not be accepted if there is not a value provided

Please indicated how quilt is to be returned to you.

___ I will pick up at the close of the show on October 3. (available between the hours of 4:15 and 5 pm; please present copy of show confirmation)

____ Please send the quilt to me via UPS at the following address:

Name ______________________________________________________
Address___________________________________________________________
City______________________ State_________________________ Zip_____
UPS Fees (including insurance) __________ Insurance fee __________
Include a check payable to UPS for the amount of the UPS fee plus insurance for shipping.

Number _______ for official use only.

Mail this completed entry form & photo, along with the fees described to:

Judy Robinson
1102 Landgraf Dr
Cape Girardeau, MO 63701

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