Custom Pillow and Cushion Order Form

Please allow 2 to 8 weeks for delivery


First Name: Last Name:
Address: City:
State: Zip:
Phone: Email Address:


Enter bill address if not same as above
Bill First Name: Bill Last Name:
Bill Address: Bill City:
Bill State: Bill Zip:
Bill Phone: Bill Email:


Enter Fabric Information
Manufacturer: Collection:
Pattern: Color:
Price per yard: Quantity:
Fabric Cost:


Enter 2nd Fabric or Trim Information
Manufacturer 2: Collection 2:
Pattern 2: Color 2:
Price per yard 2: Quantity 2:
Fabric Cost 2:


Enter Custom Pillow or Cushion Information
Pillow or Cushion Type: Pillow or Cushion Style:
Trim: Custom Trim Type:
Custom Trim Size: Finished Length:
Finished Width: Finished Height:
Zipper: How Many:
Unit Labor Cost: Total Labor Cost:



Please add Ground Shipping Charges:
Up to $34.99 ----------- add $6.95
$35 - $49.99 ----------- add $8.95
$50 - $74.99 ----------- add $10.95
$75 - $99.99 ----------- add $12.95
$100 - $149.99 ----------add $14.95
$150 - $199.99 ----------add $17.95
$200 and more ----------- add 8%

Grand Total:
Notes or Comments: