RAGSPUN QUILTING

Rhonda L. Horvath
N5515 Hwy 44-49, Brandon, WI 53919
920-346-5684 or 1-877-RAGSPUN(724-7786)  Fax: 920-346-2345
www.ragspunquilting.com
Date: ____________________________    New Acct: Y/N
Store Name: ___________________________________  Tax ID#: ________________________
Contact & Title: _________________________________________________________________
Bill to Address: __________________________________________________________________
Ship to Address:__________________________________________________________________
Phone: _____________________________________  Fax: _______________________________
Email Address: ___________________________________________________________


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Payment Method: ___Cash                                                                 Subtotal: ______________
___ Check…this must clear the bank before shipment .                   Shipping:______________  ___Credit Card(MC/VS)                                                                    Total: __________________
    CC #:_______________________________________ Exp. Date: ___________

Special Notes: