Printable Order Form

How Many?                                                                                        Amount

              DVD Introductory Pack (includes DVD and 2 prayer boxes*) $25.00 PPD (within continental United States)                                          

              DVD only  $14.00 PPD (within continental United States)                                                                                                                       

______  Video Introductory Pack (includes Video and  2 prayer boxes*)  $25.00 PPD (within continental United States)                                     

              Video only  $9.00 PPD (within continental United States)                                                                                                                       

               5 Box Pack *    $25.00 PPD (within continental United States)      English?           Spanish?                                                                  

               15 Box Pack*   $40.00 PPD (within continental United States)        English?           Spanish?                                                               

                25 Box Pack*   $55.00 PPD (within continental United States)        English?           Spanish?                                                              

                50 Box Pack*  $80.00 PPD (within continental United States)           English?           Spanish?                                                               

                                                                                                                     Total Enclosed                   

* Each shipment will include materials to help you get started.

Please send a check or money order to:
Free Prayer Box Ministry ,PO Box 724,Mount Vernon, OH 43050

Name_________________________________________________________________________________

 Street Address_________________________________________________________________________

City_______________________State_____________________Zip_______________________________

Phone Number_________________________________________________________________________