RTRFoundation-Book Order Form

The Miriam Weiner
ROUTES TO ROOTS FOUNDATION, INC.

Please print out and mail/fax completed form to:

Routes to Roots Foundation, Inc., 73 Harbor Key, Secaucus, NJ 07094
TELEPHONE 201/866-4075
FAX 201/864-9222

Name:	____________________
Address:	____________________
City:	____________________
State:	____________________
Postal Code:	____________________
Country:	____________________

Institution:	____________________
Telephone:	____________________
FAX (Optional):	____________________
E-Mail (Optional):	____________________

Please send ____ copies @ U.S. $50 of JEWISH ROOTS IN POLAND, to the above address

check or money order in U.S. funds Payable to: Routes to Roots Foundation, Inc.
(check or money order must include address/telephone number.)

Visa MasterCard Acct No. _______________ Exp: ____ / ____

	Item	Qty	Each	Total
Shipping and Handling/first book: U.S $8.00 / Foreign $15.00 Additional copies/same address, add (per book): U.S $4.00 / Foreign $6.00 Book Weight: 5 lbs. ISBN 0-9656508-0-4 (JRP)	Jewish Roots in Poland		$50.00

	NJ residents add 6% sales tax
	Shipping (1st copy)
	Shipping (additional copies)
	Total Enclosed

Alternate shipping address

Name:	____________________
Address:	____________________
City:	____________________
State:	____________________
Postal Code:	____________________
Country:	____________________

Check or Credit Card Number MUST accompany
ALL ORDERS. Books will be shipped via UPS ground
or U.S. mail (foreign orders). We cannot ship to P.O. Boxes. Orders outside the U.S. will be shipped book rate. Foreign orders MUST be in U.S. dollars.
The Routes to Roots Foundation, Inc. takes
no responsibility for packages shipped out of the country. Only defective books may be returned for replacement and must be returned within 30 days in order to be replaced.