Order Form
(Please Print)		 The Hometown Quilter
1100 N. Gale Rd. * Davison MI 48423
810-287-8816
thehometownquilter@charter.net
Mailing Address:
Name:
Address:                                                                                            Apt:
City:                                                                State:                        Zip:
Phone:                                                             Email:

Payment Method: (Check One) US DOLLARS ONLY
 International Customers must pay with credit card or Paypal only

 ___ Money Order                   ___ Credit Card
Card Number:  _ _ _ _ - _ _ _ _ - _ _ _ _ - _ _ _ _ Exp. Date:
Name on Card:   Last 3 #s on back of card _ _ _   *required

Item Description Price Qty Amount
       
       
       
       
       
       
       
       
       
       
       

Total

  

Shipping & Handling (see chart on Order Page)

 

Sub Total

  

Michigan residents add 6% sales tax

  

Total