ALCOHOLICS FOR CHRIST CATALOG ORDER FORM
Ship to: _____________________________________________________________________
Address: _____________________________________________________________________
_____________________________________________________________________
Phone: _________________________ Email: _______________________________
Method of Payment (check one)
___ Cashier's Check or Money Order(enclosed) ___ Personal Check(enclosed)
Please make checks payable to: Alcoholics for Christ
___ VISA ___ MasterCard ___ Discover
______________________________________________________ ____________________
Credit card number Month Year
Card Expiration Date
______________________________________________________
Card holders Signature
Item Description Donation
Number Quantity and Size (if applicable) Each Total
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Please contact the office for Merchandise total __________
Shipping & Handling charges.
Shipping & handling __________
For delivery outside the continental U.S.,
please call the A/C office for instructions Subtotal __________
Donation to help with A/C expenses __________
Please mail, phone or fax your order: Total __________
Phone: 248.399.9955 or 800.441.7877
Fax: 248.399.1099
Mail to: Alcoholics for Christ, 1316 N. Campbell Road, Royal Oak, MI 48067
Please allow 15 days for delivery.
Your donation is very much appreciated. THANK YOU!