First Name: I: Last Name:

Address: City: State:

Zip Code: Select One (1): Cassette Audio CD VHS Video DVD Video Date (00/11/2222):

Service: Sunday Morning Sunday Evening Wednesday Special Service E-mail:

Phone Number: (example (316) 529-0600)

Payment Type Check Money Order Mastercard Visa

For more information please call our office @ (316)529-0600 or e-mail us at: bookstore@fpcwichita.org. Thanks!