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ENTRY BLANK
(Please use a separate entry form for each quilt. Print as
many forms as you need.)
Address_______________________________________________________________________________________________________
City______________________________________________________________________ State____________ Zip_____
Telephone (____)________________________________________day (_____)_________________________eve
Name of Quilt ________________________________________________________________________________________________
Dimensions _________ inches x __________ inches
Brief description of quilt to be displayed with the quilt.____________________________________________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
Please check the category which best describes your quilt (choose only one category ---
We reserve the right to change the category if we feel the quilt is
incorrectly entered):
____ Pieced
____ Applique + Other Techniques
____ Group, Large
____ Youth
____ Small Wall Quilt
____ Wall Hanging
____ Group, Small
____ Theme
Estimated value of Quilt $____________________
(This is essential information for insurance purposes only. Any
quilt valued at over $500.00 must show proof of value, such as an
Appraisers Report. Your quilt will not be accepted if there is
not a value provided
Please indicated how quilt is to be returned to you.
___ I will pick up at the close of the show on October 1. (available between the hours of 4:30 and 5:30 pm; please present copy of show confirmation upon pick up. If another person is picking up your quilt they will need the confirmation. The confirmation will be mailed to you before the show.)
____ Please send the quilt to me via UPS at the following address:
Number _______ for official use only.
Mary K Reed
105 N. Park Lane
Jonesboro IL 62952
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