Tichel Order Form

Please order only the necessary amount of teichels you require for your mikvah's needs, based on average clients per evening.

* Number of Tichels to Order (appropriate donation $36 each):

* Shipping Method:

* I would like to make an additional donation in honor of Chof Beis Shevat:

Sub Total:	$36.00
Shipping:	$0.00
Total:	$36.00

Contact & Mikvah Information

* First Name

* Last Name

* Name of Mikvah

* Phone Number

* E-Mail Address

Credit Card Information

* Card Number

/

* CCV Number ?

Shipping Information

Please select an approriate shipping option based on your Country.

Pickup Information

Please contact us if you can't pick up your order within 1 month, to avoid a shipping and additional handling fee.

Our office is located at 312 Kingston Ave. between Union & President Streets, purple door

Billing Address

* Adress Line 1

Address Line 2

* City

* State or Province

* Zip/Postal Code

Mikvah Address

* Adress Line 1

Address Line 2

* City

* State or Province

* Zip/Postal Code

To order other items for your mikvah, please visit the Mikvah Mall and submit a separate order for those items.