Sizes:

____	Regular (Adult or Chupa) 5 1/2 ft 51' x 70' (130cm x 180cm)	x $150.00 =	$ ______
____	Youth (Bar/Bat Mitzva) 5 ft 36' x 67' (90cm x 170cm)	x $140.00 =	$ ______
____	Shawl Style 5 1/2 ft 19' x 70' (50cm x 180cm)	x $130.00 =	$ ______

Extra:
    Tefillin Bag ____     Kippa ____ (Please check one)
Color of stripes:

Classic Blue _______	Black _______	Brown _______
Burgundy _______	Green _______	Red _______

Shipping and Handling:

Post Office (EMS)= $20.00 (USA)                               Free (Israel)

Fedex = $45.00 (USA)             $10.00 (Israel)

$ ___________

TOTAL: $_______________

First Name ________________ Last Name________________________
Address ___________________________________________________
City _________ State _________ Zip ________ Country _____________
Telephone _____ - ________ E-mail address _______________________

Payment method:

Credit Card:  Master Card __  Visa __ American Express __ Number _________    Exp ___ / ___ Signature _____________________

Check Amount   $ _______ (Enclosed)

Please send this form by mail or fax to:

Mr. Benny Anderman Mitzpe Nevo 31-1 Maale Adumim 98410 ISRAEL

Tel: + 972 2 535 4204 Fax.: + 972 2 535 4204 Mobile: + 972 52 673 583

E-mail: Sales@taarig.com - Thank you for your business.