First Name * Last Name *
Address 1 * Address 2 City * Province * Postal Code * Country *
Phone *
Email *
Pattern or Quilt Name
Functional
Display
Who is the quilt for? Age (actual or at heart) Gender MF What does he/she like? (i.e nature, sports, music - be specific) Is the quilt for a special occasion? (i.e. wedding, graduation, birthday)
Quilting Pattern Selected: See the patterns
Quilting Theme Selected: (i.e. specific sport, flower, leaf, shape, etc.):
Customer gives operator creative license
Requested Completion Date
Notes