Please print, fill out, and send your monies in

Directory Order Form

Please complete for and return with paid monies to:

International Headquarters of the Pentecostal Assemblies of the World, Inc.

Office of the General Secretary

3939 Meadows Drive

Indianapolis, IN 46205

Telephone:(317)547-9541

Fax:(317)543-0513

Shipping & Mailing Information

	PLEASE PRINT CLEARLY
First Name
MI
Last Name
Mailing Address
City, State, ZIP
Daytime Phone

Quantities:
$5.00 each
Total Due:
Total Paid:

	OFFICE USE ONLY
Received By:

Note: Please keep receipt until directory has been received

© 2006 The Pentecostal Assemblies of the World, Inc. Web Team Dr. Vanuel Charles Little Jr. and Melvin Golder
Site design by Warren Communications-Oklahoma City