Mail Order Form

USE THIS FORM TO ORDER BOOKS BY MAIL
[please print out this form and complete clearly]

Your name:   _____________________________________________________________

Mailing Address:  _________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

Telephone Number:    ______________________

E-mail Address:          ________________________________

Requested Inscription:

________________________________________________________

Number of books requested:    ____   x    $18.95/ book*                     =  $___________
(*note: shipping @ $4.00/book included in price)

California residents add sales tax of 7.5% ($1.12/book)                      =  $___________

 Total price = $20.07/book                     TOTAL ENCLOSED      =   $___________

Please pay by check using this form.

PLEASE MAIL FORM TO (and make any checks payable to):

RABBI MICHAEL LOTKER
20168 VILLAGE 20
CAMARILLO, CA 93012