Place Your Order Order Form - Custom Quilts and Pillows Place your custom quilt order or pillow order here NameThis field is for validation purposes and should be left unchanged.Name(Required) First Name Last Name Email Address(Required) Residential or Business Address(Required) Residential Business Address(Required) Street Address City State / Province / Region ZIP / Postal Code Your AnswerAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country If OUT OF TOWN do you want to have to sign for your quilt? Yes No N/A Cell Phone(Required)Quilt Size(Required) Baby Quilt (made from baby/child clothing) 40 x 40 $275 - 30 pieces Lap Quilt 44 x 48 $275 - 10-15 shirts Throw Quilt 56 x 64 $350 - 15-20 shirts Twin Quilt 64 x 84 $400 - 25-30 shirts Full Quilt 76 X 88 $475 - 35 shirts Queen Quilt 84 x 92 $525 - 40 shirts King Quilt 92 x 100 $625 - 50 shirts Pillow (If want patchwork pillow please provide 3 pieces of clothing per pillow) Small pillow 12 x 12 $25 Medium pillow 16 x 16 $30 Large pillow 18 x 18 $35 What color quilt binding around the edges? (This can be decided later when you see a picture of layout)What color quilt backing? I provide black, navy, or heather gray. (This can be decided later when you see a picture of layout)Do you want a particular shirt in the center? If so, please mark it and describe it below.(Required)Due Date(Required) MM slash DD slash YYYY Who is the quilt for?(Required) Male Female Payment Method (I will contact you when I receive your order to process payment)(Required) Cash Check Venmo Apple Pay GPay Paypal (I will add 3% to total - this is what Paypal charges me) Special Instructions(Required) Contact Info 2712 Southeast 2nd Circle Lee's Summit, Missouri 64063 info@wrappedupinmemories.com (816) 830-9941
