$25.00 Single$30.00 Family
Check payable to the Colonial Coverlet Guild of America.
Due by May 1

Name:

Address:

City:

State:        Zip:      

Phone: (h)(w)

E-mail:

I am/we are a: Coverlet owner    Weaver       Dealer       Collector

Please print form and mail with check to:
Laurie Coolidge, 536 Arizona Avenue, Glenwood, IL 60425