Goose Tracks Quilts
www.goosetracks.com

Necktie Pillow, T-shirt Pillow and T-shirt Sham Order Form

Please note:  Delivery time is approximately 4 weeks.

If you have any questions, please don't hesitate to contact me.

Click here to send e-mail.

Qty = ____ Necktie Pillow(s) with pillow form insert @  $125 each =  $ _______
Qty = ____ Necktie Pillow(s) without pillow form insert @ $110 each = $  ______

Qty = ____ T-shirt  Pillow(s) with pillow form insert @ $75 each = $ _____
Qty = ____ T-shirt  Pillow(s) without pillow form insert @ $60 each = $ _____

____ Standard Size Sham - finished size approx. 26" high x 32" long, including flange (fits a 20" x 26" pillow) - $100
____ Queen Size Sham - finished size approx. 26" high x 36" long, including flange (fits a 20" x 30" pillow) - $125

  • Shipping - the cost of insured shipping is included in the price - shipments outside the continental USA will be charged at actual cost.
     
  • Sales Tax: $_____New York State residents please add applicable sales tax

    Total Price of Order: $____________[Pillow(s) + Sales Tax (in NY State)]
  • Billing Information (the address your credit card is billed to, if paying by credit card)

    Your Name: ___________________________________________________________________

    Address: _____________________________________________________________________

    City, State and Zip Code: ________________________________________________________

    Phone Number and e-mail address: ______________________________________________

    Shipping Information (if different than above):

    Name: _______________________________________________________________________

    Address: _____________________________________________________________________

    City, State and Zip Code: ________________________________________________________

    Method of Payment: (check one)
    If you prefer, you may split your payment - 50% at the time of order, and the remainder due prior to shipment of your completed quilt.   Please see Payment Options for details

    Payment amount: $________

    ___ Check or Money Order

    ___ Paypal

    ___ Charge my credit card: ___ MasterCard ___ Visa

    Account Number __ __ __ __-_ ___ __ __-__ __ __ __-__ __ __ __ __ Expiration Date: __ __ /__ __  CVC__ __ __ __ (from back of card)

    Name as it appears on Card (please print) ____________________________________________

    Signature ____________________________________________________________________

    Enclose this order form and mail your shirts or ties to me at the following address:

    Cathy Hooley
    354 Bogden Road
    Broadalbin, NY 12025
    Phone: 518-842-8700
    Please contact me if you have any questions:
    Click here to send an e-mail to cathy@goosetracks.com
    Website: http://www.goosetracks.com

    Rev. 9/15
    Pricing valid through 12/17