Willowbrook 'Windy Days' BOM Form

'Willowbrook Hexie Quilt - Hibernation'

Block of the Month Registration Form
$40 per month for 6 months
( PLUS $9.95 postage if required)
Name*

First NameLast Name
Postal Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Daytime Phone Number*

Area CodePhone Number
Would you like the 2.25” Hexagon EPP Papers pack included ($70 for all 240 needed)?

Yes please!No Thanks
POST or COLLECT:*

POST ($9.95 per month)COLLECT from Blue Mountain Heights, QLD
Our Block of the Months are charged and posted on the 1st Monday of each month. All details are securely stored. Once you have submitted your BOM Form, we will be in contact regarding your payment details. Please note that admin fees may apply if your payment details decline.

** PLEASE NOTE: by submitting this form, you are agreeing to purchase one block per month for the duration of the BOM program.
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'Willowbrook Hexie Quilt - Hibernation'