LEIS OF HAWAII

HULA GRAM ORDER FORM

Date Ordered: Date of Service:

*HULA GRAM SERVICE FOR*

PLEASE SELECT WHICH ISLAND BELOW

OAHU / MAUI  / KONA-HAWAII / KAUAI

PLEASE SELECT WHICH INDIVIDUALS ARE BEING HULA GRAM

Ladies   Men's

Teen

Child
Girls Boys Girls Boys

Company:

Name:

Address:

Contact Name:

City: State: Zip Code:

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

Fax: Area Code - E-mail:

How did you hear of our company?

*HULA GRAM INFORMATION*

CLIENT'S NAME:

Add Personalized Message For:

*Please Fill In Your Information Below*

Hula Gram Service Date: Time: (am. or pm.)

Location: Address:

Phone Number:

Contact Person: Contact Person Phone/Cell:
 

*HULA GRAM SERVICE FOR  HONOLULU / OAHU  ONLY*

*(STD) STANDARD HULA GRAM GREETING: STARTING PER PERSON: $300.00*

Standard      $300.00
Superior $375.00
Deluxe $450.00
Special $525.00
V.I.P $600.00

- - - Ladies - - Mens - - Teen - - Child  - Hula Gram Greeting  - - - - - Total

Per Person

Qty ( + + + ) X = $

Lei Description

*HULA GRAM SERVICE FOR  MAUI  / KONA-HAWAII / KAUAI  ONLY*

*(STD) STANDARD HULA GRAM GREETING: STARTING PER PERSON: $375.00*

Standard      $375.00
Superior $450.00
Deluxe $525.00
Special $600.00
V.I.P $675.00

- - - Ladies - - Mens - - Teen - - Child  - Hula Gram Greeting  - - - - - Total

Per Person

Qty ( + + + ) X = $

Lei Description

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

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

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

Payment: Visa or Master Card accepted through LEIS OF HAWAII

Credit Cards Type:

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

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 - 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 below once your Credit Card has been approved, which will confirm your order. You will be contacted by your email if there is any problem with your order.

E-mail:

Type Of Leis / Comments:

 

LEIS OF HAWAII

The Perfect Start To Your Hawaiian Holiday

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

827 Paahana Street, 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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