Order Form Please Print and Send by Mail

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To:

Dafna Moriya
P.O.B. 1483
Ramat-Hasharon 47113
ISRAEL (Air Mail)

Shipping Information

First Name: ________________ Middle Initial: ___________ Last Name:__________________

Mailing Address: _____________________________________

City: _______________ State: _______ Zip Code: _________ Country: ____________

E-Mail: ______________________ Tel: ____________________ Fax: ___________________

For shipping & handling please add $4 in the U.S. Add $7 for orders outside the U.S.

All orders must be in writing accompanied by payment in U.S. funds.
Please make checks and money orders payable to D. Moriya.

I would like to order ____ copy/copies of "Art Therapy in Schools" (soft cover), for the introductory price of $34.95 each.

                  For the total of:  $_____________


                  Postage:           $_____________



                  Total Enclosed:    $_____________

Thank you for your order.

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