Thank you and God bless you!
Name: __________________________________________________________ Address: _________________________________________________________ City: _________________________________________ State: ______________ Zip: _____________________ Phone: (________) ________________________ Email address: _____________________________________________________
MY ORDER: $120 – for 1 Prince of Peace Statue with a FREE Medallion My Check made out to America Need Fatima is enclosed. No, I prefer to use my Credit Card: Credit card number: _______________________________________ Credit card expiration: Month Card type:
Year
Visa
American Express
MasterCard
Discover
Account Holder’s Signature REQUIRED Signature: _____________________________________ Date: _____________
Thank you and God bless you!
WEBS17
America Needs Fatima P.O. Box 341 Hanover, PA 17331 America Needs Fatima is a special campaign of The Foundation for a Christian Civilization, Inc., a 501 (C)3 corporation.
MY ORDER: $120 – for 1 Prince of Peace Statue with a FREE Medallion My Check made out to America Need Fatima is enclosed. No, I prefer to use my Credit Card: Credit card number: _______________________________________ Credit card expiration: Month Card type:
Year
Visa
American Express
MasterCard
Discover
Account Holder’s Signature REQUIRED Signature: _____________________________________ Date: _____________
Thank you and God bless you!
WEBS17
America Needs Fatima P.O. Box 341 Hanover, PA 17331 America Needs Fatima is a special campaign of The Foundation for a Christian Civilization, Inc., a 501 (C)3 corporation.
