Order Form

To order by mail, complete this form, print it and mail with your check or money order to:

Quilt du Jour
c/o Made By Moms
P.O. Box 141
Hathaway Pines, CA 95233

Personal checks must clear bank before order is shipped.

Name:

Shipping Address:

City:

State:

Zip:

E-mail:

Daytime Phone:

Payment Method:

Personal Check
Money Order

2.	Quantity:	3.		Total:






	Subtotal:

4.	Shipping & Handling:		$1.00 per pattern All orders shipped USPS first class mail
5.	CA Sales Tax:

6.	Order Total:

7.	Comments:
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If you have any questions regarding your order, please contact us at orders@madebymoms.net or by phone at (209) 770-7884.

View more table toppers in our Home Decor section.