Hawaiian Aloha Fashions
WELCOME TO ORDER BY FAX
 
Please print this form and fax to 1-808-537-5216
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FAX FORM
 
BILLING INFORMATION
SHIPPING INFORMATION
  BILL TO: SHIP TO:
     
 

NAME:_________________________________

ADDRESS:_____________________________

CITY:__________________________________

STATE:________________________________

ZIP CODE:_____________________________

COUNTRY:____________________________

TELEPHONE:__________________________

FAX:__________________________________

E-MAIL:_______________________________

NAME:__________________________________

ADDRESS:______________________________

CITY:___________________________________

STATE:_________________________________

ZIP CODE:______________________________

COUNTRY:______________________________

TELEPHONE:____________________________

FAX:____________________________________

E-MAIL:_________________________________
     
1
CODE:_______________________________________ SIZE:________ COLOR___________ QTY______ $________
2
CODE:_______________________________________ SIZE:________ COLOR___________ QTY______ $________
3
CODE:_______________________________________ SIZE:________ COLOR___________ QTY______ $________
4
CODE:_______________________________________ SIZE:________ COLOR___________ QTY______ $________
5
CODE:_______________________________________ SIZE:________ COLOR___________ QTY______ $________
6
CODE:_______________________________________ SIZE:________ COLOR___________ QTY______ $________
7
CODE:_______________________________________ SIZE:________ COLOR___________ QTY______ $________
     
 
Please add $3.00 for 2XL and $1.00 for each additional sizes
     
 
SPECIAL INSTRUCTIONS:_________________________________________________________________________
     
 
NAME AS APPEAR ON CREDIT CARD:________________________________________________________________
 
CREDIT CARD TYPE: VISA_______ MC_______ DISCOVER_______ AMX_______
 
CREDIT CARD NUMBER: ___________________________________________________________________________
 
EXPIRATION DATE:________________________________________________________________________________
 
AVS # __________ the last 3 or 4 digits on the back of your C.C. by your signature/AMX in front

 

PLEASE PRINT THIS FORM AND FAX TO: 1-808-537-5216.....Thank you.
* After we received your order we will email you a confirmation with the total amount that we will be charging your C.C. including shipping and handling charges.