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VISA, MasterCard, American Express and Discover Credit Cards Accepted Please  your order without your Credit Card
informationand call 808-877-0300 with your credit card info.... or... Print out this form and FAX it to 808-877-5157 with all the necessary info. | |
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Name: ________________________________ Address: ______________________________ (Please no P.O.Box, street address only) _______________________________________ Phone: _______________________ Credit Card:(Check one) VISA___MASTERCARD___Amex___Discover___ Card# ___________________________ EXP: ________ Name on the Card: _____________________________ Signature ______________________________
Item _____________________________ Qty ____ Price ________
Item _____________________________ Qty ____ Price ________ Item _____________________________ Qty ____ Price ________ Item _____________________________ Qty ____ Price ________ Item _____________________________ Qty ____ Price ________ Item _____________________________ Qty ____ Price ________ Item _____________________________ Qty ____ Price ________ Item _____________________________ Qty ____ Price ________ Item _____________________________ Qty ____ Price ________ Shipping ________ (call for USPS, UPS or Fedex quotes) Hawaii Tax ________ (Hawaii Excise Tax of 4% will be added to all Hawaii residents) TOTAL ________ Mahalo for your order |