Enrollment

Please complete this information form and mail to:
MAP Ministry
PO Box 128
Savannah, OH 44874

$100 - New Testament     $100 - Old Testament      $150 - Both Old and New

Your Name:

____________________________________________________________
Street Address:

____________________________________________________________
City:

____________________________________________________________
State/Province:

_____________       Zip/Postal Code: _____________________

Phone Number:

____________________________________________________________
E-Mail Address:

____________________________________________________________
Comments:



Credit Card Type:

___________________    Card Expiration Date:  ____________
Credit Card Number:

____________________________________________________________
Card Holder's Name:

____________________________________________________________