| Mail to: | Missions International |
| P.O. Box 93235 | |
| Southlake, Texas 76092-3235 |
Order Form
| Name of Item | Quantity | Price | Total |
|
Shipping |
$3.00 |
||
|
Total |
|||
Method of Payment
___ Enclosed Check
___ Please Charge My: ___ MasterCard
___ VISA
Charge Card No._________________________ Exp. Date______________________
Charge Card in the name of:______________________________________________
Ship To:
Name:______________________________________ Telephone:________________
Address:_____________________________________________________________
City:_________________ State:____ Zip Code:_____________