CUSTOM ORDER PATCH FORM

Change of lettering on patch

You can print this form !!!

Please complete this form and mail it to:

Patchwork Designs, Inc.
8421 Churchside Drive
Gainesville, VA 20155

703-743-9948 PHONE
703-743-9942 FAX

 

Name__________________________________________________________________

Address_________________________________________________________________

City____________________________________State_____________Zip_____________

Phone (        )_____________________Referred By:______________________________

Email Address:___________________________________________________

Discover/Mastercard/Visa# _________-________-________- ________

Expiration Date:_______________Have you ordered before?__________________

Thank you for ordering a custom patch through Patchwork Designs. A graphic image will be sent to you upon receipt of this order form.

The pricing below does not include patches larger than 3 inches, 100% embroidered, satin twill, or metallic threads. Pricecould be less, depending on the size of the patch that needs to be revised.
         
Pricing could be cheaper depending on the patch size. Please email cheryle@patchworkdesigns.net

50-99 patches $2.20

100-199 patches $1.75

200-299 patches $1.60

300-499 patches $1.50 contact us for larger quantity.

Item #
Lettering changed to....
Quantity
Unit Price
Total Price
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SUBTOTAL
Regular Shipping & Handling (view chart)
Special Shipping ( next day, priority mail etc)
TOTAL ENCLOSED

 

 

 

 

CLICK HERE FOR SHIPPING CHART

PAGE 2 of order

Name of customer ordering______________________________________________