Secure Form Click Here for the Printable Fax Order Form
Recipient Information
Recipient's Name(s):
Delivery Date:
Island / City:

Airline:
Flight #:
Arrival Time:
Airport:

Hotel / Condo:
Tour Company:
Check In Date:
Check Out Date:

Gift Message:
Order Details
  Item: Qty: Total:
1.
2.
3.
 
[M] = Maui/Waikoloa
[O] = Other Islands
Grand Total: 
Your Information
Name:
Mailing Address:
City:
State:
Zip:
Phone:
(-
Fax:
(-
Email:
Travel Agency:

Credit Card Type:
Credit Card Number:
Expiration Date:
Name On Credit Card:
Security Code:

Comments:
You are responsible for providing accurate and complete Delivery information: Recipient Name(s), Hotel or Condo, Island and Town, Dates of Stay, Date of Delivery and Gift Message. Check your order information VERY CAREFULLY. A $10.00 charge will be applied as a result of an error in the delivery information which you provided.

We Will Make Every Attempt To Meet Your Delivery Date, But We Are Not Responsible For Delays Beyond Our Control.

Delivery, Tip and State Tax are included. There is a $4 additional delivery charge to Princeville and Hanalei on Kauai and to The Ihilani Resort on Oahu.

  
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