STAMP MINISTRY PATCH ORDER FORM

You can print this form !!!
Please complete this form and mail it to:

Patchwork Designs, Inc.
8421 Churchside Drive
Gainesville,VA 20120
703-743-9948 FAX: 703-743-9942

NEW ADDRESS, PHONE AND FAX effective August 20, 2007
 

Name__________________________________________________________________

Address_________________________________________________________________

City____________________________________State_____________Zip_____________

Phone (        )_____________________Referred By:______________________________

Email Address:___________________________________________________

Discover/Mastercard/Visa# _________-________-________- ________

Expiration Date:_______________Have you ordered before?__________________

How many stamps are enclosed?______________

Thank you for participating in the stamp ministry program.
         
SORRY WE DO NOT HAVE FREE PATCHES AVAILABLE !!
Item #
Description
Quantity
Unit Price
Total Price
ST-0708 Stamp Ministry-dove $.95 $
ST-0809 Stamp Ministry-torch $.95 $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
$ $
SUBTOTAL
Regular Shipping & Handling (view chart)
Special Shipping ( next day, priority mail etc)
TOTAL ENCLOSED

Name of customer ordering______________________________________________