Pandemic DVD Order Form

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                                                 (Print a copy for your records)

 

 Name:   

 

Telephone: 

 

Address:   

 

City/State/Zip Code:   

 

E-mail Address:

 

If ordering for a Stake, Ward, or other Church Organization,

please identify:

 

Organization:

 

DVD Order:  Pandemic DVD

 

Quantity Ordering: 1 2 3 4 More - list below

 

Additional information, if any: