Blessed be the Name - Hostess Order Form

Name :

Phone :

Email :

Date :

Address :

City :

State :

Zip :

Item Description	Size	Name of Applique	Fabric # for Applique	Additional Color Thread accent color	Monogram name or initials, cap-sensitive	Thread # for color of monogram		Cost
							$
							$
							$
							$
							$
							$
							$
							$
							$
							$

Check #:

Card Type:

Visa

Master Card

Card No. :

Exp Date :

Security No. :

Name on Card :

Hostess :
Rep :

Subtotal
Shipping & Handling
5% Tax
Total

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