Image of Jesus

Shalom Place

Shalom Place Products and Services

- Order Form for Check/Money Order Payments -


Please use this page for sending orders paid for by check or money order (USD payments only). Refer to our Products and Services page for naming items and prices.

Mail your order to:
Heartland Center for Spirituality
c/o Philip St. Romain
4101 N. Edgemoor
Wichita, KS 67220


Your Name ________________________________________________________________

Mailing Address ____________________________________________________________

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City/State/Country/Zip ________________________________________________________

Your email address __________________________________________________________

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. . . . . . . . . . Items Ordered . . . . . . . . . . . . . .. . . . . . . . . . . . . . No. Ordered . . Cost/Item . . Total

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. . . . . TOTAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ________