New Philadelphia Church Family
VIDEO/AUDIO REQUEST FORM

Print the form, complete and mail it with payment to:

New Philadelphia Church Family
c/o Administrative Secretary
1902 Dominguez Street
Carson, California 90810

 

For more information, please call the church office at (310) 830-8777 or toll free at 1-866-687-4459.

In order for you to receive the correct recording, it is important that you fill out the information below as accurately as possible. Thank You!

   
Today’s Date ____________________________________________________________
Type of recording you are requesting:
   ____Cassette   ____ CD   ____Video
 
Name: ____________________________________________________________
Address: ____________________________________________________________
City, State, Zip: ____________________________________________________________
Phone number: ____________________________________________________________
Date of the tape: requested: ____________________________________________________________
 
How many recordings are you requesting?
 Cassette  ____  CD  ____  Video ____
 
Which service?  ____7AM  ____ 10AM

Brief Description or comments:

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
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