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 Drive,  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.
Or email us:    
pjquilter11@yahoo.com
Trim and Square                                
Quilt ($10)                $___________