Media Purchasing Form
Media Purchasing Form

* First Name:
* Last Name:
* Address:
* City:
* State / Province
* Zip Code:
* Phone:
* Email:
Comment:

Media Selection
Please state beside the name of the resource whether you desire a DVD or a CD and how many of each if you are ordering more than one DVD or CD. Thank You! (Ex. (1) None Like Him DVD or (2)None like Him CD)
* What is the title(s) of the message(s) that you want to purchase?
* Give the number of DVD's you are requesting?
* Give the number of CD's you are requesting.
Please go to the online giving and make your donation by credit card or check card or you can wait until we contact you and send you payment in by check or money order. Realize that the product will be sent only after receiving your donation. Remember the suggested donation for DVD's - $11 CD's - $6

* Indicates required entry field