HEAVENLY BOUNTIES-Proclaiming the Sanctity of Human Life

Order Form {Please print out order form. Fill it out and mail it to us at: Heavenly Bounties; 990 W 48th St, Fremont, MI 49412.}

OR, you may place a telephone order for a single, sample brochure at 1-231-651-1012.

From:

Contact Person:______________________________________________

Business Name:______________________________________________

Street Address:______________________________________________

City, State, ZIP:______________________________________________

Description	Quantity	Sub Total
Total number of brochures:	______ @ $20.00/100=	$___________
Shipping Cost:	@$4.00/100 =	$___________
(Michigan orders require sales tax	@6.00%	$___________
	TOTAL:	$___________

Method of payment: Check or money order (please enclose with order)

If you want brochures shipped to an alternate address, please indicate below:

ALTERNATE SHIPPING ADDRESS

Name:______________________________________________________

Street Address:______________________________________________

City, State, ZIP___________________________________________

HEAVENLYBOUNTIES