The Book Shop Order Form

The Book Shop Order Form
Today's date

DayMonthYear
Date
Your name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email

Confirmation Emailexample@example.com
Physical Postal Address for delivery (we can't send to post boxes)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Your order - Select the book(s) you want to order by ticking the appropriate check box to the left and entering the number of books you want to order. (You will only be charged for the books where you have ticked the check box)
prevnext( X )
Grace upon Grace & Let the Voices Speak (special combo price)
$45.00 NZD Quantity



Grace upon Grace (only)
$35.00 NZD Quantity



Let the Voices Speak (only)
$20.00 NZD Quantity



Total

$0.00 NZD

Conditions of purchase - please tick each box to show you understand. Orders will not be sent unless all three boxes are ticked and payment has been made as shown below

Rows	I agree
I agree to make payment direct to the WMCANZ bank account (03-0206-0380248-000 - account name "Wesleyan Methodist Church Trust") with your name and "Books25" as the reference
I understand I must pay before my order will be sent
I understand that my order will be sent as close to the launch date (7 November) as possible

Should be Empty:

The Book Shop Order Form

Your order - Select the book(s) you want to order by ticking the appropriate check box to the left and entering the number of books you want to order. (You will only be charged for the books where you have ticked the check box)*

Your order - Select the book(s) you want to order by ticking the appropriate check box to the left and entering the number of books you want to order. (You will only be charged for the books where you have ticked the check box)