Order Form - Mission to Israel

MISSION TO ISRAEL
PO Box 248, Scottsbluff, Nebraska 69363

Order Form
Print this form, fill it out ( PLEASE PRINT! ) and mail to the address above.

Date:________________
Name:____________________________________________________
Address:__________________________________________________
City, State, Zip:_____________________________________________
Phone Number (Optional): (______)_________________
Email Address (Optional): ____________________________________

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We do not sell or rent to anyone the information you have entrusted to us.
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Thank you for supporting us.

Item
Number Quantity
Ordered Brief Description Donation

$

Total: $

Postage & Handling=10%
($1.00 minimum): $

Freewill Offering: $

Total enclosed (U.S. Funds): $

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Item Number	Quantity Ordered	Brief Description	Donation
			$













Total:			$
Postage & Handling=10% ($1.00 minimum):			$
Freewill Offering:			$
Total enclosed (U.S. Funds):			$