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Foxglove Cottage Order Form

Phone:435-462-9618
Email: contact@jeanakimballquilter.com

Name: Phone:
Address:
City: St:     Country:   Zip:
E-mail:
Method of Payment: Check ____ M.O. ____Visa ___ MC ___
Credit Card Number: Exp (mo/yr):
Signature:
Quantity
Item Name
Price
     
     
     
     
     
     
     
     
     
     
     

Shipping Costs

 Subtotal  

$10 and under - $2.50
$10.01 to $20 - $3.50
$20.01 to $30 - $4.50
$30.01 to $50 - $6.50
$50.01 and up - $8.00

 Tax (6.75% Utah)  
Shipping  

For international shipments please contact us for shipping & handling: contact@jeanakimballquilter.com.

 Total  

Send completed form to:

Jeana Kimball’s Foxglove Cottage
P.O. Box 220
Spring City, UT 84662
U.S.A.