![]() APPLICATION FORM Print out this form, fill in the blanks, and mail it to our address below. Full name and address of the organization and person initially responsible for these videos: Name_______________________________________________________________________ Organization (if any)______________________________________________________ Address____________________________________________________________________ City__________________________State_____________Zip________________________ Phone(_______) _______-__________For Free Videos, you must sign this… I am (or we are) an active prison chaplain, prison ministry or prison worker currently financially unable to purchase needed Christian videos for this ministry. I have prayerfully chosen videos in the list below which I want to use for evangelizing and discipling prisoners. If the Lord enables Christian Videos for Prisons to give me (us) these videos, I (we) promise to immediately put them to use on an ongoing basis - showing them to inmates in a prison, jail or reformatory for the purpose of winning souls for Christ. I understand that supplies and donations are limited. Lest another worthy chaplain or prison ministry be needlessly denied a video they need, I have selected only those items that I am certain I (we) will use. I (we) will supply a report on the results of our showings to Christian Videos for Prisons to let the donors know how the videos have been used and what the Lord has done. Signature________________________________________________________________ (All FREE videos are available in standard North American video format only.) The Case for Creation [info]..............NOTE: Please review the descriptions of each video before placing your order. Order only those that you feel fairly confident that you will actually put to work in your correctional institution(s). Although these videos are offered free of charge to your prison ministry, they are certainly NOT free to us. We or our donors pay for each one, plus shipping, packing, etc. So please do not waste precious ministry resources by ordering videos that you have no serious intention of using. Also, please remember that this special free offer is available only to chaplains and wardens of prisons, jails, other correctional institutions, and other legitimate prison ministries. These videos are only to be shown to prisoners and people connected with your prison ministry. They are NOT to be shown in outside churches, schools, etc. where normal retail prices apply. (complete the remainder of this form, only if you are purchasing videos at prison ministry discount) I (we) would like to put your Christian videos to work in evangelizing and discipling prisoners. For this purpose, I would like to take advantage of your SPECIAL DISCOUNT to prison chaplains and prison ministries. Please accept our order for the following items marked below. (All prices are in US dollars and are 30% or more below normal. Satisfaction guaranteed.) The Case for Creation [info] US$14........... Many other videos are available for purchase from our catalog at the prison ministry discount (http://EdenCatalog.com). Write your choices below. Shipping Charge on above purchases is 10% of total order (minimum $3.50) Method of Payment:
Card # _ _ _ _ - _ _ _ _ - _ _ _ _ - _ _ _ _ Exp. Date____/____ Name shown on Card:_____________________________________________________ Signature________________________________________________________________
Mail this form to: Christian Videos for Prisons (PrisonVideos.com) PO Box 200 Gilbert AZ 85299 Toll-free phone: 1-800-332-2261
Christian Videos for Prisons is a non-profit ministry of Films for Christ. |