Please PRINT OUT this order form, fill in the required information and send it by fax or mail to:

Quilt-Design Ute-Barbara Skjønberg, 
PB 71, 
N - 3054 Krokstadelva

Phone: +47 - 32 87 76 64 - Fax: + 47 - 32 87 29 82, 
e-mail  info@quilt-design.com

Quilt-Design.com Order sheet:          

Name:

First name:

Street:

Country/Postal code:

 City / State:

Phone:

 e-mail:

Payment: (please mark credit card you are using)

VISA

 Master

.

Card #.:

Exp. date:

CVC2 verdi*:

 Name on card:
* The CVC2 code is used to provide additional security when paying by MasterCard. It is located on the back of the card, in the signature field, and looks like "1234 567". Please indicate the last three digits of this code if you are paying with MasterCard.
Number Art.-No. Name Price /item Total
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Total nkr

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Only actual shipping costs will be added

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Date: Signature:

 

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