Order Form
All rights reserved.
PLEASE ENCLOSE A NOTE WITH YOUR CHOICES OF PATTERN, THREAD COLOR AND BATTING IF
NEEDED OR YOU CAN PRINT THIS FORM (YOU MAY NEED TO COPY AND PASTE IT INTO A WORD
DOCUMENT). SEND IT TO ME ALONG WITH THE QUILT TOP, BATTING AND BACKING IF YOU ARE
PROVIDING IT, AND A CHECK FOR THE DEPOSIT.
NEEDED OR YOU CAN PRINT THIS FORM (YOU MAY NEED TO COPY AND PASTE IT INTO A WORD
DOCUMENT). SEND IT TO ME ALONG WITH THE QUILT TOP, BATTING AND BACKING IF YOU ARE
PROVIDING IT, AND A CHECK FOR THE DEPOSIT.
NAME___________________________________________________________
ADDRESS_______________________________________________________
________________________________________________________________
TELEPHONE______________________________________________________
E-MAIL___________________________________________________________
DATE NEEDED____________________________________________________
QUILT SIZE: LENGTH__________X WIDTH__________ = ______________sq.in.
QUILT NAME/DESCRIPTION__________________________________________
_________________________________________________________________
PANTOGRAPH NAME_______________________________________________
PANTOGRAPH COST_______________________________________________
SOLID THREAD COLOR__________________________________COST___$3.00
VARIEGATED THREAD COLOR____________________________COST $7.00
BATTING CHOICE (IF NEEDED)_______________________COST____________
BACKING CHOICE (IF NEEDED)_______________________COST____________
BINDING COST (IF NEEDED)__________________________________________
RETURN SERVICE (IF OTHER THAN PRIORITY MAIL)______________________
TOTAL CHARGES__________________________________________________
MICHIGAN STATE SALES TAX (6%) (Add for batting, backing fabric, and thread only)
____________________________________
TOTAL____________________________________________________________
PLEASE INCLUDE A $25.00 DEPOSIT (OR HALF OF THE TOTAL COST OF SERVICES IF SERVICES
ARE LESS THAN $25.00) (CHECK OR MONEY ORDER). THE BALANCE WILL BE DUE WHEN THE
QUILT IS FINISHED. I WILL SEND THE QUILT BACK AFTER I RECEIVE FINAL PAYMENT.
SEND TO: KAREN'S QUILTED CREATIONS
C/O: KAREN MARTINEZ
9250 MONTGOMERY ROAD
MONTGOMERY, MI 49255
I authorize Karen Martinez of Karen’s Quilted Creations to complete the work listed above. I understand that
I am financially responsible for the cost of services rendered and for all materials used in this process. If this
quilt is displayed in a show or publication, I agree to credit the machine quilting to Karen‘s Quilted Creations.
Initial here to authorize photography and posting to my Web Page __________________

Signature: _______________________________________________________________
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Karen's Quilted Creations
I use Priority Mail for return shipping. If you have a preferred method of shipping,
please let me know on the order form.
please let me know on the order form.