ORDER FORM
Print and mail to:
Quilter's Dream, LLC
1158 Main Street
Willimantic, CT 06226
Or Call 860-456-7629
ITEM:____________________________QTY:____PRICE:______TOTAL:________
ITEM:____________________________QTY:____PRICE:______TOTAL:________
ITEM:____________________________QTY:____PRICE:______TOTAL:________
ITEM:____________________________QTY:____PRICE:______TOTAL:________
ITEM:____________________________QTY:____PRICE:______TOTAL:________
SUBTOTAL:__________________________
SHIPPING & HANDLING:_____________
- Please email us for shipping rates.
TOTAL:_____________________________
CT Residents add .06 Sales Tax:______
GRAND TOTAL:______________________
BILL TO:
NAME:______________________________________________
ADDRESS:___________________________________________
CITY/ST/ZIP:__________________________________________
FOREIGN ADDRESS1:__________________________________________
FOREIGN ADDRESS2:__________________________________________
DAYTIME PHONE:__________________________________
CREDIT CARD (VISA/MC ONLY) #:_________________________
EXPIRATION DATE:______________
SIGNATURE:__________________________________________
CHECK AMOUNT:__________________
SEND TO:(leave blank if same)
NAME:______________________________________________
ADDRESS:___________________________________________
CITY/ST/ZIP:_________________________________________
FOREIGN ADDRESS1:__________________________________________
FOREIGN ADDRESS2:__________________________________________
Quilter's Dream, LLC
1158 Main Street
Willimantic, CT 06226
860-456-7629
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