Order Form
All rights reserved.
PLEASE ENCLOSE A NOTE WITH YOUR CHOICES OF PATTERN, THREAD COLOR AND BATTING IF
NEEDED OR YOU CAN PRINT THIS FORM (YOU MAY NEED TO COPY AND PASTE IT INTO A WORD
DOCUMENT). SEND IT TO ME ALONG WITH THE QUILT TOP, BATTING AND BACKING IF YOU ARE
PROVIDING IT, AND A CHECK FOR THE DEPOSIT.

PLEASE GIVE ME AT LEAST 6 WEEKS' NOTICE IF YOU NEED THE QUILT FOR A SPECIAL OCCASION
TO AVOID DISAPPOINTMENT.



NAME___________________________________________________________

ADDRESS_______________________________________________________

________________________________________________________________

TELEPHONE______________________________________________________

E-MAIL___________________________________________________________

DATE NEEDED____________________________________________________

QUILT SIZE: LENGTH__________X WIDTH__________ = ______________sq.in.

QUILT NAME/DESCRIPTION__________________________________________

_________________________________________________________________

PANTOGRAPH NAME_______________________________________________

PANTOGRAPH COST_______________________________________________

SOLID THREAD COLOR__________________________________COST___
$3.00

VARIEGATED THREAD COLOR____________________________COST $7.00

BATTING CHOICE (IF NEEDED)_______________________COST____________

BACKING CHOICE (IF NEEDED)_______________________COST____________

BINDING COST (IF NEEDED)__________________________________________


T-SHIRT QUILT # OF BLOCKS_________________X $10 COST________________


RETURN SERVICE (IF OTHER THAN FED-EX OR PRIORITY MAIL)_______________

TOTAL CHARGES__________________________________________________

MICHIGAN STATE SALES TAX (6%) (Add for batting, backing fabric, and thread only)
____________________________________

TOTAL____________________________________________________________

PLEASE INCLUDE A $25.00 DEPOSIT (OR HALF OF THE TOTAL COST OF SERVICES IF SERVICES
ARE LESS THAN $25.00) (CHECK OR MONEY ORDER). THE BALANCE WILL BE DUE WHEN THE
QUILT IS FINISHED. I WILL SEND THE QUILT BACK AFTER I RECEIVE FINAL PAYMENT.

SEND TO: KAREN'S QUILTED CREATIONS
C/O: KAREN MARTINEZ
9250 MONTGOMERY ROAD
MONTGOMERY, MI 49255

I authorize Karen Martinez of Karen’s Quilted Creations to complete the work listed above. I understand that
I am financially responsible for the cost of services rendered and for all materials used in this process. If this
quilt is displayed in a show or publication, I agree to credit the machine quilting to Karen‘s Quilted Creations.

Initial here to authorize photography and posting to my Web Page __________________

Signature: _______________________________________________________________
Karen's Quilted Creations
I use Priority Mail or Fed-ex for return shipping (whichever is less expensive). If you
have a preferred method of shipping please let me know on the order form.