Quilter's Patch
Name: ________________________
Quilter’s Patch BOTM Thank you for choosing to participate in our Quilter’s Patch BOTM. This is a Block of the Month type program where the project is divided into 12 sets. Every month you will be given your fabrics for that month’s project. Your monthly charge includes the Quilter’s Patch book, fabrics each month and binding to complete the quilt top. The backing is not included. The cost for this project is a $20 non-refundable registration fee and $49 plus sales tax with the class and
$34 plus sales tax without the class. This cost will be billed to your credit card on or around the 1st of every month for 12 consecutive months. You may not cancel before the 12 months are up or change between “class” and “no class”. Your fabrics for the given month will be available for pick up at the shop after the 1st of that month beginning May 1, 2017. Please pick up your blocks sometime within the given month or make arrangements for shipping*. ___ I would like to sign up for Quilter’s Patch Block of the Month WITH CLASS for $49 per month plus $20 nonrefundable registration fee. OR
___ I would like to sign up for Quilter’s Patch Block of the Month WITHOUT CLASS for $34 per month plus $20 non-refundable registration fee. OPTIONAL ADD- ONS: ____ I would like to attend the Kick Off Lecture with Edyta Sitar for $10 ____ I would like the Triangle Paper Package for $7.50 +tax ____I would like the Laser Cut Applique Shapes for $43.75 +tax ____I would like the Acrylic Template Set for $50 +tax ____I would like the Aurifil Thread Set for $97.50 +tax SHIPPING OPTIONS: *____ I would like my BOTM shipped monthly for an additional $7 for 12 months. There will be additional shipping if you select any add-on items listed above. *____ I would like my BOTM shipped bi-monthly for an additional $3.50 for 12 months. Blocks will be shipped June, August, October, December, February and April 2018. There will be additional shipping if you select any add-on items listed above. Ship to: Address: _______________________________________ City: __________________ State: _____ Zip: ________
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PAYMENT DETAILS: By signing this contract you are agreeing to these conditions and giving us permission to charge your credit card monthly for 12 months. Please keep us informed of any credit card changes you may have within the given time period. Thank you for your participation! ______________________________ Name
______________________________ Phone Number
______________________________ Signature
_________________________________ Credit Card (type/last 4 digits/exp.)
______________________________ Date *If you receive a $25 Frequent Shopper Gift Card when we run your BOTM charge, it will be applied to the following month’s BOTM charge.
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Quilter’s Patch BOTM Thank you for choosing to participate in our Quilter’s Patch BOTM. This is a Block of the Month type program where the project is divided into 12 sets. Every month you will be given your fabrics for that month’s project. Your monthly charge includes the Quilter’s Patch book, fabrics each month and binding to complete the quilt top. The backing is not included. The cost for this project is a $20 non-refundable registration fee and $49 plus sales tax with the class and
$34 plus sales tax without the class. This cost will be billed to your credit card on or around the 1st of every month for 12 consecutive months. You may not cancel before the 12 months are up or change between “class” and “no class”. Your fabrics for the given month will be available for pick up at the shop after the 1st of that month beginning May 1, 2017. Please pick up your blocks sometime within the given month or make arrangements for shipping*. ___ I would like to sign up for Quilter’s Patch Block of the Month WITH CLASS for $49 per month plus $20 nonrefundable registration fee. OR
___ I would like to sign up for Quilter’s Patch Block of the Month WITHOUT CLASS for $34 per month plus $20 non-refundable registration fee. OPTIONAL ADD- ONS: ____ I would like to attend the Kick Off Lecture with Edyta Sitar for $10 ____ I would like the Triangle Paper Package for $7.50 +tax ____I would like the Laser Cut Applique Shapes for $43.75 +tax ____I would like the Acrylic Template Set for $50 +tax ____I would like the Aurifil Thread Set for $97.50 +tax SHIPPING OPTIONS: *____ I would like my BOTM shipped monthly for an additional $7 for 12 months. There will be additional shipping if you select any add-on items listed above. *____ I would like my BOTM shipped bi-monthly for an additional $3.50 for 12 months. Blocks will be shipped June, August, October, December, February and April 2018. There will be additional shipping if you select any add-on items listed above. Ship to: Address: _______________________________________ City: __________________ State: _____ Zip: ________
Page | 1 of 2
PAYMENT DETAILS: By signing this contract you are agreeing to these conditions and giving us permission to charge your credit card monthly for 12 months. Please keep us informed of any credit card changes you may have within the given time period. Thank you for your participation! ______________________________ Name
______________________________ Phone Number
______________________________ Signature
_________________________________ Credit Card (type/last 4 digits/exp.)
______________________________ Date *If you receive a $25 Frequent Shopper Gift Card when we run your BOTM charge, it will be applied to the following month’s BOTM charge.
Page | 2 of 2
