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

Your name:   ____________________________________________________________

Mailing Address:  _________________________________________________________

            _________________________________________________________

                     ____________________________________________________________________________

Telephone Number:    ______________________

E-mail Address:          ________________________________

Requested Inscription:  ________________________________________________________


Number of books requested:    __________   x    $1
6.95/ book* =  $___________
(*note: shipping and handling @ $2.00/book included in price)

        California residents add sales tax of 7.25%                =  $___________

                                                     
 TOTAL ENCLOSED       =  $___________

P
lease pay by check


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

RABBI MICHAEL LOTKER
2
0168 VILLAGE 20
CAMARILLO, CA 93012
Order Form