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    $14.95/ book* =  $___________
(*note: shipping and handling @ $2.00/book included in price)

               California residents add sales tax of 7.25%                =  $___________

                                                             TOTAL ENCLOSED       =  $___________

You may pay by Visa, MasterCard or American Express

CREDIT CARD NUMBER:  ___________________________________________________

                     Exp. Date:  _________________

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

RABBI MICHAEL LOTKER
TEMPLE NER AMI
4098 CALLE TESORO, SUITE D
CAMARILLO, CA 93012
805-388-3824
FAX: 805-383-1011