I sew it to the back. then for any lap or bigger size quilt I press it out and fold it to the front, then use elmer's school glue to glue it to the front, making sure it's just barely beyond the line of stitching-like one thread beyond. Then I use a zig zag stitch to sew it down on the front. If it's a wall quilt I just fold it to the front, use clips (since I won't be washing any glue out) and stitch it. I don't care what it looks like on the back for wall quilts.