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Order Form

Name:  
Address:  
   
City:  
State:  
Zip:  
Phone: Day  
Phone: Night  
Email:  
Official PayPal Seal

Make Checks Payable to: Darlene DeVries
Pattern or Style of Quilting Design

Heirloom  Custom    Freestyle   Panto   Meander

 Size of Quilt:

Length _______inches      Width _______inches
Cost: refer to chart in the pricing page  
quilting $
batting $
backing $
binding $
misc. $
S & H $
Insurance $
total: $
Payment is to be sent with your order.

 

Paid by:

Check    money order  paypal  ($6.00 extra fee)  

Fill out, print, and mail with your quilt to:
Quilted Treasures
Darlene DeVries
948 E. 950 N.
Wheatfield, IN 46392 		questions? email: leenie@jasperremc.coop

between 8am and 8pm (CST) phone: (219)-956-3285