| Name: |
___________________________________________________________ |
| Address: |
___________________________________________________________ |
| City: |
_____________________________
State: _______ Zip: ____________ |
| Phone: |
(opp)_____ - _____________ Bus.
Phone: _____ - _________________ |
| E-Mail: |
(opp)______________________________________________________ |
| Country |
(if other than
US)_____________________________________________ |
| Ship to: |
___________________________________________________________ |
| Address: |
___________________________________________________________ |
| City |
______________________________
State: _______ Zip: ____________ |
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| Qty. |
Description |
Price Ea. |
| ______ |
Think
About it...
Why should I be a member
of The Church of Jesus Christ
of Latter-day Saints?
Purchase Price
Includes Tax, Shipping
& Handling. A $4.00 Value
|
$10.00 |
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Total: |
____________ |
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Print this Order Form Using Your
Computer's Printer
Within the US, you are welcome to send a Personal Check or Money Order, along with
the Order Form to:
S&J Liberty
Publishing
P.O Box 1583,
Queen Creek, AZ 85142
Make all checks payable to Samuel Jeppsen
Special Instructions: (autographed,
autographed to, inscription or...)
(Hand Write on From) |
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