Beged Ivri Order Form

Order Form

You may pay for your purchase by credit card, check or money order.

Please send checks and money orders to:
Beged Ivri
P.O. Box 61495
Jerusalem, ISRAEL

Fill out your credit card details below.
Alternatively you can print out this order form, and fax it to us at (+972-2) 625-9050.

Billing Details Please enter your details here exactly as they appear on your credit card statement.

	Surname
	First Name
Address:	Street

	City
	State	Zip
	Country
	Phone	Fax
	E-mail

Shipping Details (if different from above):

	Surname
	First Name
Address:	Street

	City
	State	Zip
	Country
	Phone	Fax
	E-mail

Please send me the following:

	Quantity	Catalog Number	Description	Price
Year 50 Coins
		SHC-50	Year 50 Shekel Coin Collectors' Issue	$34.95
		SHP-50	Year 50 Shekel Coin Proof Issue	$1250.00
		SHR-50	Year 50 Shekel Coin Regular Issue	$19.95
Year 51 Coins
		SHC-51	Year 51 Shekel Coin Collectors' Issue	$34.95
		SHP-51	Year 51 Shekel Coin Proof Issue	$1250.00
		SHR-51	Year 51 Shekel Coin Regular Issue	$19.95
Year 52 Coins
		SHC-52	Year 52 Shekel Coin Collectors' Issue	$34.95
		SHP-52	Year 52 Shekel Coin Proof Issue	$1250.00
		SHR-52	Year 52 Shekel Coin Regular Issue	$19.95
Year 53 Coins
		SHC-53	Year 53 Shekel Coin Collectors' Issue	$24.95
		SHP-53	Year 53 Shekel Coin Proof Issue	$1000.00
		SHR-53	Year 53 Shekel Coin Regular Issue	$9.95
Pidyon HaBen Set
		XPB-50	Pidyon haBen Set -- Boxed 10 Half-Shekel Coins	$295.00

Credit Card Information

Credit Card

Number Expiry Date

ID number if ordering by credit card in Israel.

In Accordance with Israeli law, V.A.T. will be added to all orders made with Israeli credit cards or checks, as well as to orders for delivery within Israel.

Comments:

Please note that if you are paying by credit card, your statement will show a charge for this purchase from Marksman.

Press this button to send us your order information:

Credit Card
Number		Expiry Date
ID number	if ordering by credit card in Israel.