Quilt Block Directions

CONSENT FORM FOR QUILT BLOCKS

Please Print this form and submit with Quilt block!

I give my consent that the Quilt block I am submitting in honor of :

_____________________________________________________

It will be placed in the Agent Orange Victims and Widows Support Network

"Quilt of Tears" project for all time, henceforth. I understand that the Quilt

block will be permanently placed in a quilt.& I agree to these terms

out of love, respect and honor for our Nation’s Agent Orange Victims.

Name of Veteran being honored:

_________________________________________

Name of person submitting block:

_________________________________________

Address:

_________________________________________

Telephone Number: Email Address:

_________________________ ___________________________

Signature:

_________________________________________

Date:

____________________________

Relationship to veteran being honored:

_________________________________________

Directions For Making A Quilt Block & Submitting It To The

"Quilt Of Tears" Project

Cut two blocks 20 1/2 x 20 1/2 inches of orange background fabric.

PLEASE LEAVE 1/2 INCH SEAM ALLOWANCE AROUND THE OUTSIDE SO THAT WE HAVE ROOM TO SEW THE QUILT BLOCKS TOGETHER!

The extra block is to be sent as well to be used as part of the quilt backing. Information on main block should be Veteran's full name, rank if desired, branch of service, date of year or years served in Vietnam, unit Veteran was assigned to, base or camp Veteran was assigned to where exposure occurred, Veteran's present health condition due to Agent Orange, if Veteran is deceased state cause of death and age of Veteran at time of death. We would like to also ask you to include the state of residency somewhere on the Quilt block.

Other information on block could be Veteran's nickname in Vietnam, picture of Veteran, unit patches, branch of service emblem, ribbons or medals awarded to Veteran, etc.., etc... Blocks can contain any of the following: patchwork, embroidery, appliqué, cross stitch etc.. etc..

Wording and lettering can be done in fabric pen or fabric paint in any color desired.

PLEASE!!! Make use permanent markers & pens! Also make sure that any items that are used on the Quilt block is securely attached !!

If you do not have a Vietnam Veteran to make a block for, blocks with patriotic themes will be accepted. Blocks can be sent any time as these quilts are constantly being constructed.

This "Quilts of Tears' project has letters of acknowledgment and endorsement from the Agent Orange Coordinating Council and the Vietnam Veterans of America Inc.. It is our hope that the Quilts will be displayed every year during the Memorial Day holiday in Washington, D.C. & are also present at the In Memory Ceremony each year. Plans for the Quilts to travel to various Veteran's functions and reunions are always ongoing & a welcome event!

Please send all finished Quilt Blocks with Consent Forms to:

Agent Orange Victims & Widows Support Network, Inc.

Henry & Shelia Snyder

P.O. Box 90

Davenport, Florida 33836

For any questions, concerns, or further information please contact us by Email, Phone, or regular mail!

Henry & Shelia Snyder

Phone# 863-422-7788

Fax # 863-421-2333

Email ArmrdAngel@aol.com