LEIS OF HAWAII

MONEY LEI AND ROSES ORDER FORM

Date Ordered: Date of Service:

*(No shipment will be sent out until)*

1. Payment has been completely deposited into Leis Of Hawaii account.

2. Payment excepted only by, wired funds, money orders, cashiers checks, direct deposit, cash, business or personal checks is required before shipping.

Important Notice: All out of state checks - A 10 business days waiting period is required for all out of state checks to clear banking process.

(Please allow a week for mailing in money orders or cashiers checks.)

Please Check Here For Payment Type:

PLEASE CHECK ONE - SHIPPING TO BUSINESS - SHIPPING TO RESIDENCE

Company Ship To:

c/o Name:

Address:

City: State: Zip Code:

Phone: Area Code - Ext: 1-800 or 888: -

Fax: Area Code - E-mail:

Contact Name:

How did you hear of our company?

*MONEY LEI*

Qty () X

TOTAL = $

*MONEY ROSES*

Qty () X

TOTAL = $

NO MINIMUM ORDER

PRICES: Prices are subject to charge.

MERCHANDISE CLAIMS and RETURNS:

Claims must be made on the same day of receiving shipment.

SHIPPING INFORMATION and CHARGES:

Prefer United Parcel Post. Federal/Express optional.

Box Handling & Shipping charges are at customer's expense.

Name To:

Add Personalized Message To Card:

BOX CHARGE: MAINLAND - NEIGHBOR ISLAND - INTERNATIONAL

Qty () - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - $

PACKING/HANDLING/INSURANCE ($20.00 PER BOX)

If You Would Like Shipping Charges Included With Shipping Item. Please Check Below.

SHIPPING CHARGE: MAINLAND - NEIGHBOR ISLAND - INTERNATIONAL

Qty () - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - $

SHIPPING FED/EX, POSTAL SERVICE ($35.00 PER SHIPPING BOX)

If you wish to use your own Personal or Business

Federal Express Account Number - Enter It Below

*Freight Not Included - Postal Service or Federal Express*

POSTAL SERVICE

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - SUBTOTAL $

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - HI Tax 4.712% $

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - TOTAL DUE $

Your Credit Card Information Below Will Only Be Kept On File.

FOR SECURITY REASON AND TO DOUBLE PROTECT YOUR CREDIT CARD INFORMATION

WE ASK IF YOU WOULD EMAIL SEPARATED (3) INFORMATION BELOW

1. Credit Card Number, 2. Name On Card, 3. Email Address

To: - leisofhawaii808@gmail.com

Payment: Visa or Master Card accepted through LEIS OF HAWAII

Credit Cards Type:

1. Card No:

This Credit Card Will Not Be Valid Unless You Submit Your

Last 3 Digit Numbers Located On The Back Of Your Credit Card:

Exp. Date: 00/00

2. Name Of Person As It Appears On The Card:

Credit Card Billing Address:

City: State: Zip Code:

Phone: Area Code - Ext: 1-800 or 888: -

Fax: Area Code - 3. E-mail:

When complete, click "submit" to email Leis Of Hawaii. If you wish to have a hard copy of your order, please print "Form Confirmation " page after submitting. Please allow processing time. You will be contacted by your email address below with information to where to wire funds or if there is any problem with your order. Please mail in your payment of money orders, cashier checks, cash, business or personal checks to:

Leis Of Hawaii / 827-A Paahana Street / Honolulu, Hawaii 96816

E-mail:

Comments:

LEIS OF HAWAII

The Perfect Start To Your Hawaiian Holiday

Toll-Free Reservations: 1-888-534-7644 (1-888-LEIS-OF-HI)

827-A Paahana / Honolulu, Hawaii 96816

(808) 732-7385 or Fax (808) 732-7134

E-mail: leisofhawaii808@gmail.com

Visa or Master Card accepted through LEIS OF HAWAII

Web page publishing and graphic design by: LEIS OF HAWAII

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