Fax Order Form For Tapes

Fax this form to

773-262-7866

Chicago Community Kollel 6506 N. California Chicago, IL 60645

Or call 773-262-9400

Date_____________

Attn: Ephraim Polatsek

Please prepare the following tapes for me. I Would like to pick them up in
the Office / Beis Medrash (please circle choice).

Name:________________________ Membership Number:__________

Telephone:(__)____________ Fax:________________ E-mail:_______________  

	Title	Tape Number
1
2
3
4

Alternate choices if above tapes aren’t available.

1
2
3
4
5
6