Order Form For "Phone Call From God"

MAIL THIS FORM, ALONG WITH YOUR CHECK TO:

Duane Smith Ministries, Inc

P.O. Box 7

Randolph, Kansas 66554

QTY

SELECTION

Email Evangelist Duane Smith for more sermons: duanesmithministries@juno.com 

MERCHANDISE TOTAL:

             SHIPPING COSTS:

$   0.00   -  $ 20.00,  add  $2.50

$ 20.01   -  $ 40.00,  add  $3.50

$ 40.01  -  $100.00,  add  $4.50

TOTAL AMOUNT OF ORDER:

Signature: ___________________________________   Date: ________________

Mailing Instructions:

1. Please type or print all information on this order form.

2. Make check out to Duane Smith Ministries, Inc.

3. Be sure that you provide all information requested.

4. If you have a P.O. Box, please be sure to include a street address as well.

SHIP TO:  

FIRST & LAST NAMES ________________________________________

ADDRESS 1__________________________________________________

ADDRESS 2__________________________________________________

CITY__________________________ STATE ________  ZIP __________

EMAIL ADDRESS ____________________________________________

Home Telephone (         )  ____  -  __________

{Please provide your phone number in case a problem arises with your order.}

"Your contact information will be kept confidential and will not be given to others."