Fax Order Instructions:

(Suggestion: you can print this page to use as an order form.)

1. Please send us the following information:
   
   Name:_________________________________________________________
   Address:________________________________________________________
   City:__________________________________State:______Zip:___________
   Country (if not U.S.):_____________________________________________
   
   Phone (we will call only if we have delivery questions):   (_____)_____________
   
2. Amount:__________, based on where your order will be shipped to: (see below)
   
   To US addresses ($25.95 per book + $6.95 S&H) = $32.90 per book.
   To all California addresses (add $2.27 tax)  = $35.17 per book.
   To all Canada addresses ($25.95 per book + $19 US airmail) = $44.95 per book.
   To all other International addresses ($25.95 per book + $26.00 International airmail) = $51.95 per book.
   
   
3. Please complete the following:
   
   Mastercard     Visa      American Express      Discover     (circle one)
   
   Card number: ___________________________ Expiration date (mm/yy): ____/____
   
   Signature: _______________________________
   
4. Fax this order form (the above information in any format is ok if you do not have a printer) to: 714-842-4694.
   
   Please allow 3 - 4 weeks for delivery of fax orders.  If you require faster delivery, please consider using our secure Online order system (with delivery options as fast as 1 day via UPS.)  Click here to return to our main order page.  
   
   Click here to e-mail us at feedback@culinarykidneycooks.com if you have any further questions!

Thank you for ordering "Cooking for David: A Culinary Dialysis Cookbook"!

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