JDM Tracts

Non-Imprinted, Customer Order Form

Mailing information
Organization: _______________________
Attention: __________________________
Address: __________________________
City: _____________________________
State: ______________ Zip: _________
FAX: _________________________ 		Charge my:    __MasterCard    __VISA
Card number: __________________
Expiration date: ________
Name on card: _________________
_____________________________
Signature of cardholder (required)
You may phone us your card number; however, we must have a copy of this form FAXed or mailed.
Shipping information
Organization: _______________________
Attention: __________________________
Address: __________________________
City: _____________________________
State: ______________ Zip: _________
Phone: _______________________
                (required to complete your order)
Address is:    __Residential    __Business/church 		To order, print this Order Form, then:
  • FAX completed form to
         260 373-2002, or
  • Phone the information to
         260 373-0601, or
  • Mail it to: PO Box 80343,
         Fort Wayne, IN 46898

    Make Checks payable to JDM Tracts

    		•
    Tract Title Quantity Price Shipping Subtotal
    101 How to Know for Sure* __100     __  500
    __200     __1000     		     
    201 Heaven—4 Keys __100     __  500
    __200     __1000     		     
    301 If You Died Today** __100     __  500
    __200     __1000     		     
    * Translations available for Tract 101:
    Check one:    __English     __Spanish     __German     __Russian
    __Romanian     __Somoan     __Swahili     __Kenyan     __Gipende

    ** Translations available for Tract 301:
    Check one:    __English     __Spanish     __German     __Philippino

    		6% tax (IN)  
    Total  

    Thank you for your order!

    JDM Tracts, PO Box 80343, Ft. Wayne, IN 46898    Tel: 260 373-0601    Joe@JDMRobes.com

    [This form also available in .JPEG format]