Name____________________________________________

Address__________________________________________

City_____________________________________________

State__________Zip________________________________

Phone____________________________________________

Quilt Pattern_________________Thread Color___________

If you want me to choose the pattern and thread color,
check here_____

Quilting                     $__________

Binding                      $__________

Double Batting          $__________

Cotton Batting           $__________

Cotton/Poly Batting   $_________

Backing                     $__________

S&H                          $__________

           Total                          $__________           


Special Instructions:
                                         PJ's Machine Quilting Order Form                                     
          
Please print this form, fill it out and then mail it to me with your quilt and payment to: PJ's Machine
Quilting, Skyview Dr., Marshfield Mo., 65706.  If you need more order forms you can print them from my
website at
www.pjsmachinequilting.com.  Call me at (417)859-0859 with any questions.