candidates

Please print out and mail/fax completed form to:
Routes to Roots Foundation, Inc., 136 Sandpiper 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: ____ / ____

Shipping and Handling/first book:
U.S $10.00
Foreign $35.00 (available only by air)

Additional copies/same address,
add (per book):
U.S $8.00 / Foreign $10.00

Book Weight: 5 lbs.
ISBN 0-9656508-0-4

Item	Qty	Each	Total
Jewish Roots in Poland		$50.00
NJ residents add 7% 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 by air. 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.

The Routes to Roots Foundation, Inc. is a Not-For-Profit Corporation,
in accordance with Section 501(c)(3) of the Internal Revenue Code.
Registered in the States of New York and New Jersey.
Copyright ©1989-2008 by Miriam Weiner - ALL RIGHTS RESERVED
This material (text, images, database) may not be published, broadcast, rewritten, or redistributed.

All information and graphics use d on this website are either copyrighted © by Miriam Weiner, or are used with permission of the copyright holder (including photographers, cartographers, archives and institutions and publications). Permission to reproduce or display in any form must be obtained from the owner/copyright holder of each illustration.