BETHEL MINISTRIES
PINE CAR DERBY CD ORDER FORM 2008

If you would like to order a copy of the derby pictures 
and statistics on CD, please print out this form. Then 
circle the CD(s) of your choice, include payment, and 
either send to Bethel c/o Pastor Josh Plonk, or return in
an envelope to your child's teacher who will get it ordered.
You should recieve your CD within 2-3 weeks either by mail
or through your child's teacher.

				   Cost	 Qty	Check#
* 2000-2004 "Special Edition" CD  $3.00	 ____	_______
* 2005 Pine Car Derby CD	  $3.00	 ____	_______	
* 2006 Pine Car Derby CD	  $3.00	 ____	_______	
* 2007 Pine Car Derby CD	  $3.00	 ____	_______	
* 2008 Pine Car Derby CD	  $5.00	 ____	_______	

  ( make all checks payable to Bethel Baptist Church )

					TOTAL $_______

Name:___________________________________________
Address:________________________________________
City:___________________ State:____ Zip ________
Phone:_________________ Other:__________________
Teacher: (if child attending SCS)_______________

BETHEL BAPTIST CHURCH
Attn: Pastor Josh Plonk
200 North Roselle Road
Schaumburg, IL 60194
(847) 885-3230