Ship To: The Quilt Studio 4429 So. 50th St. Omaha, NE 68117 Order Form Name:______________________ Size: _____in. x _____in.= ______sq. inches Home Address:________________________ ________________________ ________________________ E-Mail_______________________________ Phone:_________________(H) _________________(W) Price Level: ($40.00 minimum on all orders) ____ Basting Only @ .0075 cents per sq. in ____Overall Pantograph Pattern @ .0135 cents per square inch ____Custom @ .0325-.04 cents per sq. in (please call) Pattern Name:______________________ Batting: ____ Customer Provided ____100%Dream Cotton .25 per inch 90" wide ____100%Dream Cotton .35 120" wide ____Polydown .18 per inch 90" wide ____Polydown .25 per inch 120" wide ____Heirloom Blend (80/20) .25 per inch 90" wide ____Warm & Natural .25 per inch 90" wide ____Warm & Natural .35 per inch 120" wide Backing: ____Customer Provided ____108" backing fabric $8.50 per yard color____________ ____Natural Muslin $8.50/yd.(90" wide) ____White Muslin $8.50/yd.90" ____Printed Cotton $6.50/yd. ______Color:________ $6.50/yd.(45" wide) Thread: ____Cotton ____Cotton Wrapped Poly Core ____Monofiliment $3.00 charge ____Variegated $3.00 charge Color______________ Binding: ____.13/ linear inch: Cut and pieced, machine stitched again to front with mitered corners to finish ____.25/linear inch: Cut and pieced,machine stitched to front, trimmed, and hand stitched to back with mitered corners to finish ____.005/linear inch attached to front only Hanging Sleeve:_____Yes (add $10.00) _____No Return Shipping: UPS_______ Fed Ex______ Basic Shipping Charge is $13.00 includes up to $300 insurance ESTIMATED TOTAL: Balance: The balance of the quilt sevrice is due when quilt is ready to be shipped. Payment: Payment by Check_____ Credit Card____ Paypal_______ Name on card: ___________________ Account Number#_____ _____ _____ _____ Expiration ___ /___ Special Instructions:_____________________________________________________ _____________________________________________________________________ _____________________________________________________________________ Thank You for your order!