PRINT THIS ORDER FORM AND MAIL WITH PAYMENT
(please make check or money order payable to Patricia Borg)
Little Chicky Creations

PO Box 224
Stillwater, MN 55082
E-Mail: rubyk@winternet.com

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Circle Payment Method:          Check   Money Order
Name:(print & signature)
Address:
City:
State & Zip:
Telephone:
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Item Name and Description

Price Each

Quantity

Total

Please answer the following questions regarding your order: (circle choices)

 

    

This quilt is for a: Boy   Girl   Either

 

    

This person is a: Baby   School Aged Child   Teen   Adult   Senior

 

    

I would like the predominant colors to be: (circle 2 - 3)
White   Pink   Lt. Yellow   Lt. Blue   Lavendar   Red   Blue   Yellow   Green

 

    

Terry Crib Quilt

$24.95

    

Coordinated Satin Binding

$5.00

    

Subtotal:

  

Shipping and Handling: ($4.95 X number of quilts ordered)

 

Minnesota Residents Please Add 6.5% Sales Tax:

  

Please allow 3 - 4 weeks for delivery.

Total :