Name____________________________________________

Address__________________________________________

City_____________________________________________

State__________Zip________________________________

Phone____________________________________________

Quilt Pattern_________________Thread Color___________

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

If you want the free 3.3 ounce polyester batting,
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, 17 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.