Quiltaholics - Mailin Order Form

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Date ___/___/2000 Name __________________________________ Address ________________________________ _______________________________________ City _____________________ State _________ Zip _______-______ Phone (_____) ____-______ Email __________________________________		Print and Mail this form to: Quiltaholics PO Box 6204 Holliston, MA 01746-6204 Checks in U.S Funds only. Make Checks payable to: Quiltaholics
Pattern ID	Pattern Name	Price	Qty	Total
RP-0001R	A Touch of Ireland	$8.00		$
RP-0002R	'Tis the Season	$6.50		$
RP-0003R	Southwest Whatever	$8.00		$
RP-0004R	Which Star?	$8.00		$
MP-0001	Omaha Connection	$8.00		$
MP-0002	Forever Spring	$6.00		$
MP-0003	Open and Closed	$8.00		$
Shipping Costs: U.S. States.....$1.50 Canada.............$2.00 Overseas.........$3.00 Bounced Checks will be subject to a $15 Fee. Thank you for your order!		Subtotal		$
		Shipping		$
		MA residents add 5%		$
		Total		$