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| ORDER FORM - PRODUCT(S) FROM CARLOS ORTIZ |
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| please print; fill out; and mail with payment • Questions? Call (954) 981-6405 |
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| (or: click on Card for credit card payments) |
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| CD's $15.00 • Teaching Series (soon available) |
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PURCHASER
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PLEASE SEND TO:
Leave blank if same as purchaser
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NAME:
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NAME:
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ADDRESS:
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ADDRESS:
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PHONE:
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PHONE:
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EMAIL:
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EMAIL:
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| Check / Money Order Number: _____________________________________________________ |
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| Please make checks and money orders payable to Carlos Ortiz and mail to: |
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| Carlos Ortiz; c/o New Life Assembly of God; 7885 Pines Blvd, Pembroke Pines, Fl 33024 |
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