| 
 After filling out ALL fields below, Print and Mail to the address on the 
                            right
 (Note: all applicable fields on this form must be filled in
to process your order) 
Business Name.:
(If a Business or Church Check)
First Name....:
Last Name.....: 
Address.......: 
City..........:
State.........:
ZIP Code......:
Phone number..:
EMail address.: 
Suggested Donation Amounts:
 Taking the size of the church into consideration, we are 
 suggesting the following donation levels:
Church Membership  Suggested Donation* (Annual) 
 Less Than 50  $10.00 to $15.00 
 50 to 100        $15.00 to $20.00 
 100 to 200      $20.00 to $30.00 
 200 +             
$40.00 to $50.00
  
 
 | 
 
 |  
 
 |