Mishloach Manot order form: Personal Details: First Name: Surname: Phone Number : Address: Email: Order: (Choose a quantity you would like to order for anything over 10, please email [email protected]) Small Mishloach Manot: 1 2 3 4 5 6 7 8 9 10 Medium Mishloach Manot: 1 2 3 4 5 6 7 8 9 10 Large Mishloach Manot: 1 2 3 4 5 6 7 8 9 10 Purim Cards: 1 2 3 4 5 6 7 8 9 10 Payment: Cash Cheque Credit Card Mastercard Visa Name on Card: Card Number: Month of Expiry: Year of Expiry: -We wish you a happy Purim- This page uses 128 bit SSL encryption to keep your data secure.