Resource Order Form iF YOU DO NOT WISH TO USE OUR ONLINE SHOPPING CART, PLEASE PRINT THIS ORDER FORM, COMPLETE IT WITH YOUR CREDIT CARD NUMBER — OR INCLUDE A CHECK OR MONEY ORDER IN U.S. FUNDS — AND SEND IT TO:  MIDWEST CHRISTIAN OUTREACH P.O. BOX 446 WONDER LAKE, IL 60097-0466 We Accept:

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ITEM #	DESCRIPTION	QUANTITY	SUGGESTED DONATION	TOTAL
CHARGE TOTAL AMOUNT TO MY:  VISA  MASTER CARD  DISCOVER CARD # ___________-__________-__________-__________, EXP. _____/_____ I’VE ENCLOSED CHECK OR MONEY ORDER PAYABLE TO MIDWEST CHRISTIAN OUTREACH.			Subtotal	US$
			15% Shipping	US$
			Optional Donation	US$
			Total Amount:	US$

SEND ITEMS TO:

NAME:	_________________________________________________________________________________
STREET ADDRESS:	_________________________________________________________________________________
CITY & STATE OR PROVINCE:	_________________________________________________________________________________
ZIP/POSTAL ZONE:	_________________          EMAIL: _____________________________________________________
PHONE:	(__________) ____________________________

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