Life's a Stitch
 Family Patch Pillow of Wall Quilt Order Form

Please print out and fill in and send this and we will send a Paypal request for the total or send along with your check, money order made payable to:

Life's a Stitch
1492 Circle Drive
Knoxville, Iowa 50138

Please Circle Which One  Family Pillow Wall Quilt
Please Circle Which One in each column if having 2 fabrics - or - circle: PATCHWORK for patchwork fabrics Swatch 1: A,B,C,D,E,F,G,H,I,J,K,L,M,N,
O,P,Q,R,S,T,U,V,W.X.Y,Z,AA,BB		 Swatch 2: A,B,C,D,E,F,G,H,I,J,K,L,M,N,
O,P,Q,R,S,T,U,V,W.X.Y,Z,AA,BB
8 names maximum at this time.
Pricing per name for regular swatches:
2/$44.00   3/$55.00   4/$66.00   5/$77.00   6/$88.00   7/$99.00   8/$109.00
Please write in first names EXACTLY as you want them below (you can add your dog or cat, too!  same pricing) and then other info
For patchwork style please add $14.00 to above totals for up to 5 people, and $24.00 for 6-8 people
Hair color choices:  black, blonde, brown, auburn (red)
Skintone choices:  medium or dark
Dog or cat color:  black, brown, blonde-yellow, red-orange, white (it will be cream color after tye dye) or calico cat
  Name in order of appearance Male/Female Hair Color Skintone Cat/Dog
1          
2          
3          
4          
5          
6          
7          
8          

Total   (please add up all the names and extra pricing if choosing patchwork)            

$
Please be sure to add shipping and tax (if you live in Iowa)

Customer Information

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