Off-line Order Form
Please print and fill out this form. Then phone, fax, or mail your order to us.
Billing Address: Shipping Address:
Name:_____________________________
Address:__________________________
     _____________________________
City:_____________________________
State:______ ZipCode:_____________
Country:__________________________
Phone:____________________________
Fax:______________________________
eMail:____________________________
Name:_____________________________
Address:__________________________
     _____________________________
City:_____________________________
State:______ ZipCode:_____________
Country:__________________________
Phone:____________________________
Fax:______________________________
eMail:____________________________
Item # Description Unit Price Quantity Extended Price
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Subtotal: ______________
Postage and Handling (See chart on previous page): ______________
(Hawaii Residents Only) State Tax (4.169%): ______________
Total Cost: ______________
Paid by Cashier's Check: _______ Money Order:_______ Credit Card:_______
Visa:_____ Master Card:_____ American Express:_____ Discover:_____
Card Holder's Name: _______________________________________
Card Number: ___________________________ Expiration Date:___/___

Gift of Hawaii · 41-1403 Kumuula St. · Waimanalo, HI 96795-1225 · Ph/Fax: (808) 259-8557
E-mail: order@giftofhawaii.com

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All rights reserved.