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Postal Mail Order Form

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Print this page and send your order to 

The Life Center         8335 Winnetka Ave.,  #107        Canoga Park, CA  91306

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I am Enclosing a Donation to support the Pro-Truth Team.
Please send me the online E-books indicated below:

                                     Item                                                       Donation     Product #

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(___)    AN  INTERVIEW  WITH  THE  DEVIL  . . . . . . . . . . . . . . . .

$12              (# 7211) 

 $ ________

(___)    ABORTION -- The Secret Religious War  . . . . . . . . . . . . . .

$12              (# 7222) 

$ ________

(___)    Both Books -- Devil Interview and Secret Religious War  

$21              (# 7223)

$ ________

A Blissful Yoni Dance 

(___)    Volume One --  "Close Encounters of the Best Kind"   . . . .

$12              (#1111)

$ ________

(___)    Volume Two --  "The Gift"    . . . . . . . . . . . . . . . . . . . . . . . . . .

$12              (#1122)

 $ ________

(___)    Both Books -- Volume One and Volume Two   . . . . . . . . . . 

$21              (# 1133)

$ ________
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I am Enclosing a Donation to support the Pro-Truth Team.
Please send me the printed pro-choice booklets indicated below:

                                                                                                                                   Minimum order = 10 copies

(___)    Why I Am Pro-choice!                   Please send me _______ copies     $2       (# 1622)

 $ ________

                                                                                                                                    Minimum order = 10 copies

(___)    How to Keep Abortion Legal        Please send me _______ copies     $2       (# 1643)

 $ ________

                                                                                                                                   Minimum order = 10 copies.  

(___)    The Separation of Church and State    Please send me _______ copies  $2 (# 1676)

 $ ________

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I  Enclose a  Non-Tax-Deductible Donation to support the Pro-Truth Team.
Please send me the medallions indicated below:

(___)    I am  enclosing an additional donation of  . . . . . . . . . . . . .

$10            (# 77-10)

 $ ________

(___)    I am  enclosing an additional donation of  . . . . . . . . . . . . .

$50            (# 77-50)

 $ ________

(___)    Please send me all four of the E-books listed above  . . . . .

$100           (# 77-100)

 $ ________

(___)    A Beautiful, Silver  Wheel of Life Pendant ($160 Value) 

$300          (# 77-300)

 $ ________

(___)    Two Beautiful, Silver  Wheel of Life Pendants ($320 Value)

$1,000      (# 77-1000)

 $ ________

(___)    A Beautiful, Gold Wheel of Life Pendant  ($1,500 Value)

$3,000      (# 77-3000)

 $ ________

_____  I am  enclosing an additional non-tax-deductible donation of  ................................

 $ ________
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I am Enclosing a Tax-Deductible Donation to The Life Center.
Please send me the medallions indicated below:

(___)    I am  enclosing an additional donation of  . . . . . . . . . . . . .

$10              (# 88-10)

 $ ________

(___)    I am  enclosing an additional donation of  . . . . . . . . . . . . .

$50              (# 88-50)

 $ ________

(___)    Please send me all four of the E-books listed above  . . . . .

$100           (# 88--100)

 $ ________

(___)    A Beautiful, Silver  Wheel of Life Pendant      ($160Value)

$300           (# 88-300)

 $ ________

(___)    Two Beautiful, Silver  Wheel of Life Pendants ($320 Value)

$1,000       (# 88-1000)

 $ ________

(___)    A Beautiful, Gold Wheel of Life Pendant     ($1,500 Value) 

$3,000       (# 88-3000)

 $ ________

_____  I am  enclosing an additional tax-deductible donation of  . . . . . . . . . . . . . . . . . . . . . . .

$ ________
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Total amount of donation enclosed  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

 $ ________

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Make your check or money order payable to The Life Center

Do not send cash.  
If you send cash and it gets lost, you are solely responsible.

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Mail to:

The Life Center

8335 Winnetka Ave.,  #107

Canoga Park, CA  91306

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Please print Clearly

Your Name:_______________________________________________

Mailing Address:___________________________________________

City:_____________________ State:__________  Zip:___________

E-mail Address:  __________________________________________

Phone Number:  ___________________________________________

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Whom do you know that we should contact regarding the abortion issue:

Their Name:______________________________________________

Mailing Address: __________________________________________

City:_____________________ State:___________ Zip:__________

Their E-mail Address: ______________________________________

Can we say that you referred them to us  _____ YES  _____ NO

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Please share your thoughts and opinions with us.

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Copyright © 2000 --  Revisions Copyright 2001-2004   Rev. Robert E. Coté

All rights reserved    For details, see: Terms of Use  ---   Privacy Statement

r79    ---  Postal Mail Order Form

http://www.choice101.com/r79-book-mail-order-form.html

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