AGENT EMES PRINTABLE ORDER FORM

Please print out this Order Form and mail or fax it back to us

Please ship me 

No. Copies

TITLE

 VHS DVD (circle format choice)
_____  The Agent Emes DVD Bundle (episodes 1-5)  $74.95
_____  Agent Emes, Episode 1 “The Fish Head”  $9.95 $17.95
_____  Agent Emes, Episode 2 “Rabbi-Napped $9.95 $17.95
_____  Agent Emes, Episode 3 “Case of the Missing Pushka” $9.95 $17.95
_____  Agent Emes and the Giant Ego $9.95 $17.95
_____  Agent Emes and the Happy Chanukah $19.95
_____  Agent Emes: Hard To Forget (part 1) $21.95  $17.50 PRE-ORDER NOW and SAVE 20%

PLEASE ADD $4.95 FOR SHIPPING AND HANDLING (overseas order will be charged more)

BILLING ADDRESS:

Name  ____________________________________________________
Address 1 _________________________________________________
Address 2 _________________________________________________
City___________________________ State ______ Zip _____________

Email Address:  ________________________________
Phone Number ________________________________
Cell Phone ___________________________

PAYMENT TYPE:

BY CHECK:
Personal or cashier’s check accepted via regular Mail

BY CREDIT CARD (via Mail or fax):
Card Type:  VISA            MASTERCARD            AMEX             DISCOVER

Credit Card Number: ________________________________________
Exp Date _________________________________
Name on Card: ______________________________________________

SHIPPING INFO (If different than above)

Name  ____________________________________________________
Address 1 _________________________________________________
Address 2 _________________________________________________
City___________________________ State ______ Zip _____________

When you have completed filling in this form, you can

FAX IT:  1 (309) 423-8980

Or Mail it to us at

Reel Jewish Entertainment
1512 Murray Ave
Pittsburgh, PA 15217