MinistryWare Order Form Disciple Software These questions are to help us identify you in our records. Please be sure to give a contact number so that we can get in touch with you if any problems arise. Church Name_____________________________________________ Street Address____________________________________________ City_________________________ State______ Zip______________ Phone________________________ Fax________________________ E-Mail___________________________________________________ Contact Person____________________________________________ These questions are to help us determine who is using the program and who is not. They help us get an idea of what is needed in future versions. Estimated Membership Size_________________________________ Church Denomination______________________________________ Will this product be used by more than 1 person?________________ Do you currently use computers in your church?_________________ If you have any comments/complaints/suggestions then please use this space to let us know. We intend to make this product the best in its class, but we can only do so if we get feedback from the people using it. _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ Please include a check or money order for $95.95. This includes the $89.95 sale price, tax and shipping and handling. Please mail this form and your payment to: Disciple Software PO Box 912 Bryant, AR 72089