The basic method of making embroidered cards begins with a brass paper-pricking stencil, a pricking tool and a pricking mat (to protect your work surface).  You begin by placing your chosen card face up on your mat and taping the stencil (with low tack tape) onto the card.  Following the pattern on the stencil, use the pricking tool to make the holes ready for you to sew through .
As long as it will fit through the holes in your card any thread can be used but many people favour metallic threads. Attach your thread to the inside of the card with sticky tape and using a suitable needle, embroider the pattern.  You can stitch all or part of the pattern as it suits your design.  When you have finished stitching, tape down the end of the thread. Any untidiness on the inside of the card can be covered up later.
The card in the photograph has been made using a Trapeze Stencil.   The stencil is used to cut an aperture with a central piece left in place.  A pattern is stitched from the edge of the aperture to the centre.  The supporting card is then cut away leaving the central piece suspended on the threads.  Frames, additional embroidery, decoupage and decorative papers have been added to finish off the card.
Sprinkle embossing powder over the image and tip off the excess, then heat what’s left with a heat gun until it melts (only a few seconds). Repeat this until you have enough for your required number of layers.
Cut out your layers just outside the embossed lines, making each one smaller than the last, then apply glue and glitter to the parts that will be seen on each layer.
Stick double sided foam pads to the back of all but the largest piece and layer them up. Attach the completed Medallion to a suitable card and you have a special card for a special person.