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Please complete the form below and print a copy of the form
to be sent with your quilt top when mailed:

Country Memory Quilting
1960 Crossroads Cemetery Rd.
Harrison, AR. 72601
(870)743-3107

Name:  

Address:

City:  State:

    Phone:  E-mail:

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*Quilt Size in Inches:  

Backing Enclosed: Yes   No 

Quilt Pattern:    Thread Color:

If you are binding the Quilt yourself with the Backing Material Please Let Me Know so you will have enough too Bind!!

Binding to be added: No    Yes 

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Please include below any additional information or comments
you want to include with your order:

* Remember to indicate the TOP of your quilt with a safety pin
or another type of marker.  We can not remove puckers or tucks that
already exist on your quilt top and all loose threads should be clipped.

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