Quilting Intake Form
Customer’s Name: ______________________________________ Date: _________________
Address: ______________________________________________________________________
City: ______________________________ Province: _______ Postal code: _________________
Home Phone: ______________________ Cell Phone: __________________________
Email: ______________________________________________________
Quilt Information:
Quilt Name, Colour and/or description: ___________________________________________________________
Quilt Top Size: Width: _________ x Length: __________ = ________________Square Inches
Quilt Back Size: Width: _______________ x Length: ___________________
Directional Top: Yes/No__________ Directional Back: Yes/No___________
Quilting Pattern Choice: _________________________________________________________
Thread: _________________________________________ Specialty? Yes/No_________
Batting: □ Customer supplied. □ Painted Pony supplied. □ Hobbs Heirloom 80/20 $17/yd.
□ Hobbs Polydown $15/yd.
Anticipated Delivery Date: _____________________________________________________
Customer Pick Up □ Local delivery (in town) □ Shipped via Canada Post at additional cost □.
Design notes: _____________________________________________________________________________
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*Permission to post photos online: ____________ Please Initial
Painted Pony Quiltworks
202 – 53 First Ave. Orangeville, ON L9W 1J2 (519) 216-7575
Email: paintedponyquiltworks@gmail.com
Please note that quilt must be paid for and picked up within 30 days of completion unless prior arrangements are made. Quilts not paid for within 30 days become the property of Painted Pony and will be donated.