Date: __________________________________
 
Your Name: ________________________________________________
 
Your Address:   This is the address where your quilt will be returned:
_______________________________________________________
 
_______________________________________________________ 
 
Day Phone: ________________________________
 
Night Phone: ________________________________
 
Quilt Description: ___________________________________________________________
_________________________________________________________________________
 
Quilt Top Size: _______ x _________
 
Quilt Backing Description: ____________________________________________________
 
Backing Size:  _______ x ___________  (Backing must be at least 8" wider and 8" longer than top.)
 
Batting Type (if sent) ________________________________________________
 
Batting Size (if sent) _______ x ______ (Batting must also be at least 8" wider and 8" longer than top.)
 
Type of Quilting Desired (just a hint . . we'll discuss this in detail:
______________________________________________________________________________
______________________________________________________________________________
 
Amount of insurance required when quilt is returned to you: $_______________
 
Send to:  
 
Judy Laquidara
713 Timberbrook Drive
Nevada, MO  64772