The Cotton Cabin- Printable Order Form
 Print this form for easy mail order. Complete your order, send along with your check, money order or credit card info to:

The Cotton Cabin
 374 Bluff Street
Dubuque, IA 52001
Phone: 563-582-0800
info@cottoncabinquilts.com

QTY

ITEM # and NAME

PRICE

TOTALS

 

 

$

$ 

 

 

$

$ 

 

 

$

$ 

 

 

$

$ 

 

 

$

$ 

 

 

$

$ 

 

 

$

$ 

 

 

$

$

 

 

$

$

 

 

$

$

 

 

$

$

 

 

$

$

 

Subtotal

 

Domestic Shipping
Add 15%

IA Residents Add  7% tax

 

Shipping- 15%

 

Total

CREDIT CARD INFORMATION

Name on Card -

Card Number -

Expiration. date                                       CIRCLE ONE:    VISA       M/C      DISCOVER

CUSTOMER INFORMATION

Customer Name

Address

City                                                           State                      Zip Code

Home Phone #                              Work Phone #                                Email Address

All sales are final.