The Hawai'i Store Fax Order Form
Print a copy, fill in information and fax to 808-841-8829
or email to info@dahawaiistore.com

Qty

Item #

Description

Size

Color

Unit Price

Sub Total

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
             
             

 Merchandise Total:

 

 Date Merchandise Needed:


Contact Information (required)

 Name:

 

 Date:

 

 Phone/Fax:

 

 E-Mail:

 

 Your personal information will not be shared with anyone


Billing Information

Name:

 

 Street Address:

 

 Street Address line 2:

 

 City:

 

 State:

 

 Postal Code:

 

 Providence (non-USA):

 

 Country:

 

Shipping Information (if different)

Name:

 

 Street Address:

 

 Street Address line 2:

 

 City:

 

 State:

 

 Postal Code:

 

 Providence (non-USA):

 

 Country:

 


Please sign here

 I have read and agree to ordering terms and disclaimers.
Click Here to See Terms