THE FOUR CUPS - RECOVERY HAGGADAH ORDER FORM
1 Book: $20.00 + $6.00 S+H = $26.00
Pack of 5: $90.00 + $12.00 S+H = $102.00
Pack of 10: $170.00 + $18.00 S+H = $188.00
Case of 28: $420.00 + $40.00 S+H = $460.00
Total Cost:
Billing Information
First Name:
Last Name:
Email:
Phone:
Address
City
State
Zip
Shipping Information:
US Address ONLY!
First Name:
Last Name:
Address:
City:
State:
Zip:
Payment Information:
Charge will appear as "Shluchim Office International"
Payment Info
Card type:
Visa
MasterCard
American Express
Discover
Name as on Card:
Credit card number:
Expiration:
Month
01 - January
02 - February
03 - March
04 - April
05 - May
06 - June
07 - July
08 - August
09 - September
10 - October
11 - November
12 - December
Year
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
CardID (CVV):
?
Card Billing Address:
City:
Zipcode:
State:
Country:
Email for receipt: