The Tales from the Zirzameen - Book Order Form

Name:_____________________________________________________________________________

Address:___________________________________________________________________________

City:________________________________________State______Zip:________________________

Phone:___________________ Number of Books at:$34.30 each________Total Amount:_________

Please print form, fill out information, make check payable to Brian H. Appleton, and mail to:

5669 Snell Avenue

PO Box 126
San Jose, CA 95123