Quilt Intake Form
Customer Information
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Quilt Details
Type of Quilt
Patchwork
Appliqué
Whole Cloth
Other
Quilt Size
Lap Quilt
Twin
Full/Double
Queen
King
Other
Quilt Theme or Design Preferences
Preferred Colors
Quilting Style
All-over
Custom
Edge-to-Edge
Other
Batting and/ or backing provided by DillonsJen
Yes
No
Backing Fabric Preferences
Additional Requests
Binding to be performed by DillonsJen
Yes
No
Special Instructions or Requests
Preferred Completion Date
-
Month
-
Day
Year
Date
Budget Range $
Submit
Should be Empty: