You may also email this form to us

Design Specifications:

Shape of Patch
Size of Patch
Quantity Needed
Background Type	Twill 100% Embroidered
Background Color
Outside Trim Color
Details and their colors
You are allowed to choose 9 colors, including outside trim
Backing Type	PVC Iron-On Self-Adhesive PVC is the default choice. Self-Adhesive and Iron On require a slight increase in price
Delivery Date Needed	Project will arrive 3-4 weeks after completed sales agreement
Exact Lettering and Color
Budget Price per Patch

Contact Information:

Name
Street Address
City
State
Zip Code
Country
Phone
E-mail Address

You can also fax, or mail the completed form and design or idea.

Fax: (703) 743-9942

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

Questions:
Email: cheryle@patchworkdesigns.net
Phone: (703) 743-9948

***All custom items need to be paid in full prior to shipment.
If you have a credit card on file, we will charge this card unless otherwise noted on your file to do otherwise.