Order by Fax

To order by fax, please print out this page, fill out the information required, sign the bottom, and fax it to one of the following numbers:

• Israel: (02) 679-7470
• United States: (720) 247 0942
• From other countries: +972 2 679 7470

Fields marked with a (*) are mandatory.

*Number of copies of DoroTree:
(Prices detailed here)

*Delivery:
(Normal or Express - shipping costs detailed here)

*Credit Card Type:

*Card number:

*Card Expiry Date (MM/YY):

*Cardholder's First Name:

*Cardholder's Last Name:

*Billing Address:

*City:

*State:

*Country:

*Zip/Postal Code:

*Telephone:

E-mail:

*Fax:

Shipping Information

Fill out only if shipping information is different
than the billing information above

Ship to Name:
Shipping Address:
City:
State:
Country:
Zip/Postal Code:
Telephone:
E-mail:
Fax:

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