1000 Pillow Project


Thank you for choosing to donate or lend an embroidered pillow or photo/jpeg of a pillow to the 1000 Pillow Project.

In order to make the upcoming exhibit more meaningful we would appreciate it if you could take a few minutes to fill out the following sheet for each of the pillows/photos that you are submitting. We know you may not know all of the details but any information you can provide will be very helpful. Use extra paper if needed.  Scan, photograph, or send the information sheet(s) with the pillow or photos/jpegs.  Thank you.

To make a copy of this page just highlight everything. Right click on your mouse or click on edit and then click on save. The open a page in WORD and paste this page in WORD. Print the page out and fill it out.


Larisa Sembaliuk Cheladyn

11250-102 STreet

Edmonton, AB  T5G 2E3

Name of Donor:_________________________________________                        Date:__________________________

Pillow # _________    Actual Pillow submitted  ___yes   ___No

Photo(s) are attached     ___Yes    ___No         (for best results set digital camera at best resolution and/or 300dpi)

 Full Front____    Full Back_____      Back of embroidery____   Close-up detail of embroidery _____

Description:  Background pillow colour_______________

         Embroidery thread colours_____________________________________________________

1.       Who embroidered the pillow?  Name, Date of Birth/death


2.       How are you related to the person that embroidered the pillow? (e.g. Daughter, neighbor)


3.       How did you get the pillow? (e.g. Inherited it,  It was a gift, bought it at Value Village)


4.       Where was it embroidered? City, Province, Country? (Canada, Ukraine, Poland, other)


5.       Approximately what year was it embroidered?  (e.g. 1920’s,  before WWII,  1962)


6.       What was the source of the pattern?  (e.g. pattern book, blouse sleeve, made it up)


7.       What was the source of fabric and threads? (e.g. Ukrainian Bookstore, sugar sack, I don’t know)


8.       Do you know how it was originally displayed ( e.g. on the back of a couch, on the bed)


9.       Were there any other matching pieces (e.g. another matching pillow, side pieces)


10.    Was it embroidered for a specific occasion? (e.g. Baba got it as a wedding gift, birthday gift to niece)


11.    Were you/ anyone allowed to touch it or was it only for display?


12.    Do you have any memories attached to it? (e.g. always displayed at Christmas, used for a secret pillow fight, displayed with favourite toys)


13.    Any other significant information about this pillow? (e.g. was once part of a museum display, it was part of room decor when the Bishop visited)