Order Form - 
New or Change of Mailing Information
Print out the order form, fill in the items you wish to order and mail it to :

Ethiopian Outreach Ministry
P.O. Box 2241
York, PA  17405
Phone: (717) 846-2041
Fax: (717) 846-9847
E-Mail Address:  eom@eomusa.org


 

ORDER FORM
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For office use only
No.
Description
 Item Number Quantity Unit Price Postage Fee Total Price
1.            
2.
            
3.
            
4.
            
5.
 
 
 
 
 
 
6.
 
 
 
 
 
 
7.
            
8.
 
 
 
 
 
 
9.
 
 
 
 
 
 
10.
 
 
 
 
 
 
11.
            
12.
            
TOTAL......................=> 
 $

 
Address you want your order shipped to: 

Name _________________________ 

Address _______________________  Apt. # _______

City  _________________  State  ______ Zip Code _______

Telephone ( ____  )  _____ - __________  (optional)
 

 ___  Personal Check

___  Money Order

___  Visa        ___  Mastercard     ___  American Express

Credit Card #  ____________________ Exp. Date ______

Signature (Approving to charge the amount of purchase plus s/h.)

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