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.
         
Pricing could be cheaper depending on the patch size. Please email cheryle@patchworkdesigns.net

50-99 patches $2.50

100-199 patches $1.85

200-299 patches $1.65

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

Item #
Lettering changed to....
Quantity
Unit Price
Total Price
  $ $
  $ $
  $ $
  $ $
  $ $
  $ $
  $ $
  $ $
  $ $
  $ $
  $ $
  $ $
  $ $
  $ $
  $ $
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______________________________________________