Please Print

African Jewelry Order Form

Donation/Order From: Name:________________________ Address:___________________________ Phone:________________________	Send to: Name:________________________ Address:_________________________ ______________________________
Name of Product(s) and Number:	Price for each:





















	Shipping: $2.50
	Total Donation:

Please send donation with order.

Please mail form to: Bill & Cathy Hoffman, 810 Sizerville Road, Emporium, PA 15834

Please make checks payable to: Valley Christian Assembly

If you need more than one order form, please print another. Put the total donation amount on the last page.