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Culture Wars Tel: (574) 289-9786 206 Marquette Avenue Fax: (574) 289-1461 South Bend, IN 46617-1111 E-mail: fidelitypress@sbcglobal.net
Quantity: Price: Amount:
Culture Wars e-Subscriptions ______ @ $35 = $____.____
CW Paper Subscriptions (U.S.) ______ @ $49 = $____.____
Title of Book, CD, or DVD:
___________________________ ______ @ $____.____ = $____.____
___________________________ ______ @ $____.____ = $____.____
___________________________ ______ @ $____.____ = $____.____
___________________________ ______ @ $____.____ = $____.____
1st book: $6 S&H ($8 if Jewish Rev. Spirit) & $3 for each added book $____.____
$3 S&H for 1st DVD/CD or $5 S&H for up to 5 of them: $____.____
Tax Deductible Donation: $____.____
AMOUNT ENCLOSED (add Amount column): $____.____
E-Mail address: ____________________________
BILL TO: ____________________________ | SHIP TO:(IF DIFF.)__________________
ADDRESS 1: _________________________ | ADDRESS 1: _________________________
ADDRESS 2: _________________________ | ADDRESS 2: _________________________
CITY: ______________________________ | CITY: ______________________________
STATE/PROVINCE: ____________________ | STATE/PROVINCE: ____________________
ZIP/POSTAL CODE: ___________________ | ZIP/POSTAL CODE: ___________________
COUNTRY: ___________________________ | COUNTRY: ___________________________
Phone: _____________________________
METHOD OF PAYMENT:
__ CHECK/MONEY ORDER (US$$)
__ VISA __ MASTERCARD CARD #: ____________________________
Security Code: __________ EXPIRATION: _________
SIGNATURE if using Credit Card: _______________________________