Pattern Order Form

Valerie Henry Dance Ministries

P.O. Box 335

Lancaster, PA 17608

Type in the appropriate information and print.

PLEASE ALLOW 3-4 WEEKS FOR RECEIPT OF YOUR PATTERNS.

Have a question? Please check our Frequently Asked Questions section!

1.Please provide the following information:

Name

Street address

Address (cont.)

City

State/Province

Zip/Postal code

Country

Phone (w/area code)

E-mail

Dance group represented

Church represented

2.Please provide the following ordering information: see price chart

QTY

DESCRIPTION SUB-TOTAL

plus $1.00 per pattern S&H*

Total enclosed

other countries click here

t3.Is your shipping address the same as above?

Yes No

SHIPPING ADDRESS

Ship to

Street address

Street address (cont.)

City

State/Province

Zip/Postal code

Country

4.Would you like to be informed about upcoming VHDM events via e-mail?

Yes

5.How did you hear about this website?

Previous VHDM mailing

Local Sacred Dance group

Local Church

Word of mouth

Just found it

Internet referral

Other

6. Make check payable to: Valerie Henry Dance Ministries (VHDM)

Name
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
Phone (w/area code)
E-mail
Dance group represented
Church represented

	SHIPPING ADDRESS
Ship to
Street address
Street address (cont.)
City
State/Province
Zip/Postal code
Country

Pattern Order Form

Return to Patterns Return to Valerie Henry Dance Ministries main page