River Heritage Quilt Show ENTRY BLANK
Arena Building, Cape Girardeau, MO 63701, Saturday September 22 and Sunday September 23, 2010
(Please use a separate entry form for each quilt. Print as many forms as you need.)

Name(s)_________________________________________________________________
(List the names of all the people who worked on the quilt. If more than one participant, it must be entered in a Group category.

Address_______________________________________________________________________________________________________

City______________________________________________________________________ State____________ Zip_____

Telephone (____)________________________________________day     (_____)_________________________eve

Name of Quilt ________________________________________________________________________________________________

Dimensions _________ inches x __________ inches

Brief description of quilt to be displayed with the quilt.____________________________________________________

______________________________________________________________________________________________________________

______________________________________________________________________________________________________________
Please check the category which best describes your quilt (choose only one category --- We reserve the right to change the category if we feel the quilt is incorrectly entered):
____ Pieced ____ Applique + Other Techniques ____ Group, Large ____ Youth
____ Small Wall Quilt ____ Wall Hanging ____ Group, Small ____ Theme
Estimated value of Quilt: $____________________
(This is essential information for insurance purposes only. Any quilt valued at over $500.00 must show proof of value, such as an Appraisers Report. Your quilt will not be accepted if there is not a value provided Please indicated how quilt is to be returned to you.

___ I will pick up at the close of the show on September 23. (available between the hours of 4:30 and 5:30 pm; please present copy of show confirmation upon pick up. If another person is picking up your quilt they will need the confirmation. The confirmation will be mailed to you before the show.)

____ Please send the quilt to me via UPS at the following address:
Name ________________________________________________________________________________________________________
Address______________________________________________________________________________________________________
City______________________________________________________________________ State__________ Zip_____
UPS Fees ____________________ Insurance fee ____________________
Include a check payable to UPS for the amount of the UPS fee plus insurance for shipping.

Number _______ for official use only.

Mail this completed entry form and photo, along with the fees described to:
Mary K Reed
105 N. Park Lane
Jonesboro IL 62952

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