REQUEST FORM • Christian Videos for Prisons • PrisonVideos.com at ChristianAnswers.Net

APPLICATION FORM

Print out this form, fill in the blanks, and mail it to our address below.
Currently we can ONLY make this offer available to prisons in North America.

Full name and address of the organization and person initially responsible for
these videos:

Name_______________________________________________________________________

Organization (if any)___________________________________________________________

Address_____________________________________________________________________

City__________________________State_____________Zip______________________

Phone(_______) _______-__________ home office

Email____________@______________

Name of prison facility and general location_______________________________________

__________________________________________________________________________

_______________________________________________________

For Free Videos

I am (or we are) an active prison chaplain, prison ministry or prison warden 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________________________________________________________________

General description of correctional institution and/or intended use of these videos:

___________________________________________

Please describe your INTENDED USE and HOW OFTEN you plan to use these videos:

___________________________________________

Why do you feel that you need these videos free-of-charge?

___________________________________________

(All free videos are available in standard North American video format only.)
In English:

The Case for Creation
A Crisis of Character
Countdown to Eternity
Forgiven
The Genesis Solution
The Great Dinosaur Mystery
Left Behind
ORIGINS series
A Question of Origins
The World that Perished

In Spanish:

Con Quein te Vas? (With Whom Will You Go?)
The Great Dinosaur Mystery
ORIGINS series
Rescatodos del Infierno (Rescued from Hell)
Ropa Nueva Felipe (New Clothes for Felipe)
The World that Perished

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.

For Purchase at Prison Discount

The Lord is supplying our ministry's financial needs through other means. However, I (we) would still 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.

(For complete discriptions, see the Films for Christ on-line catalog at www.ChristianAnswers.Net\catalog) (All prices are in US dollars and are 30% or more below normal. Satisfaction guaranteed.)

In English:

Apocalypse… US$21
Are You Going to Heaven?… US$14
The Case for Creation… US$14
Countdown to Eternity… US$14
Faith Lessons… US$24.40 per set
Forgiven… US$10.50
The Genesis Solution… US$14
God's Story… US$14
The Great Dinosaur Mystery… US$14
Jesus… US$14
How Jesus Died… US$14
Left Behind… US$8
ORIGINS series… US$69
Revelation… US$21
Startling Proofs Skeptics Pack… US$14
Teen Sex: Challenge and Decision… US$14

In Spanish:

God's Story… US$14
The Great Dinosaur Mystery… US$17
ORIGINS series… US$90
The World that Perished… US$17

Shipping Charge on above purchases is 10% of total order (minimum $3.50)

Method of Payment: Check Money Order VISA

MasterCard Discover

Card # _ _ _ _ - _ _ _ _ - _ _ _ _ - _ _ _ _ Exp. Date____/____

Name shown on Card:_____________________________________________________

Signature________________________________________________________________

Mail this form to:
Christian Videos for Prisons
PO Box 200
Gilbert AZ 85299

Toll-free phone: 1-800-332-2261, ask for Prison Videos Director

Christian Videos for Prisons is a non-profit ministry of Films for Christ.

Phone 480-507-3621
E-mail

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