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 West Coast Church of Deliverance
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BILLING AND SHIPPING INFORMATION

Please make sure the billing information you enter is the same as the billing address for the credit card with which you plan to pay. When you have completed the following form, please click SUBMIT INFORMATION below to continue to the payment page. NOTE: Fields marked with an * are required.

 BILLING INFORMATION    SHIPPING INFORMATION
  APO/FPO address, click here   My shipping is the same as my billing information.
* Full Name:
Exactly as it appears on your card
  * Full Name:
* Street Address:   * Street Address:
  Street Address (cont.):     Street Address (cont.):
* City:   * City:
*   *
* Zip/Postal Code:
Enter 'NA' if not applicable
  * Zip/Postal Code:
Enter 'NA' if not applicable
* Area:   * Area:
* Phone Number:   * Phone Number:
* Email Address:     Email Address:

ADDITIONAL INFORMATION   SHIPPING METHOD
  Discount Code (if applicable):   * Choose Shipping Method:
Custom  
  Enter donation amount: $
  If you enter a dollar amount in the box above, it will be added to your order.
  Message and Comments:  
   
Proceed to the Payment Page.



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