Please print this form, mail to me with your payment to PJ’s Machine Quilting,
17 Skyview Drive, Marshfield, Mo. 65706
(417-859-0859) — pjquilter11@yahoo.com
Name_______________________________________________
Address______________________________________________
City________________________________________________
State____________________ZIP_________________________
Phone______________________________________________
Quilt Pattern________________ Thread Color_____________
For me to choose the pattern and thread color, check here______
If you want the free batting, check here____________________
Quilting $_________________
Binding (includes trim and square) $_________________
Backing $_________________
Double Poly Batting $_________________
Cotton Batting $_________________
Cotton Poly Batting $_________________
Trim & Square ($10.00 optional) $_________________
S & H $_________________
TOTAL $_________________
INSTRUCTIONS: