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Request a Quilt

If you would like to request a quilt for you or someone you know please fill out the form below.  Make sure you check your email address as that is the one we will contact you with.  Also try to include as much as information as you can about the person who the quilt is for

What is your name?


Where are you from?


Your E-mail address? *must be valid
please make sure you have entered it in correctly



Name of the person who is to receive the quilt?


Sex?
Male
Female


Their age?


Their illness?


Their religion?


Would squares of a religious theme be acceptable?
Yes
NO


Any particular themes the person would like? i.e. flowers, animals, house and home.
The more you sepcify the more likely it will be that you receive the quilt in a shorter amount of time



Any particular themes the person would dislike? i.e. flowers, animals, house and home.


Additional comments about the person this quilt is for and their illness etc.