SendLeis.com Online Product Order Form
Please Read our How to Order Section First

Entries marked with an fcrequired.gif (934 bytes) are required to process the order.
Delivery is only available for USA at this time. Please call us for other orders!

Item # Qty Item Name Price
Each		 Price
Total
Subtotal

All Leis are shipped FedEx overnight

Shipping charges are $23 for the first lei

$2.00 each additional lei

Call for bulk shipping rates

 

 Shipping
Misc
THANK YOU FOR YOUR ORDER Total Due

PAYMENT INFORMATION: CREDIT CARDS

Credit Card Type

Card Number

Expiration Date

Cardholder Name

I prefer to pay by Check or Money Order - (Sorry, NO COD's)
Sent From:
Name
Company Name
Address
City (full name)
State/Province
Zip/Postal Code
Country
Phone:
Fax:
Email:
Deliver this order to:
Name
Address
City (full name)
State/Province
Zip/Postal Code
Country
Phone:
Delivery Instructions: Please sign the gift card the way you want your name to appear. If you don't want your name on the card, please check here!
Gift Card Message: 
Special Instructions: 
Delivery Date: (mm/dd/yy)
Occasion:
Account Number
Please enter your SendLeis.com Account Number.
Your phone number is your SendLeis.com Account Number unless you were previously assigned a different number.
Include your area code and use only the numbers (ex: 5551234567).
 
  

All orders prepaid or credit card purchase only.
IMPORTANT NOTICE BELOW
Your bank statement will list: Call Hawaii Travel as our credit card processor.
You Will Receive Two Charges On Your Statement

1st Charge on your statement is the:
       Date Order was Placed: This charge includes: Your Box Charge of $15.00 and the Flowers placed in the box.

2nd Charge on statement is the:
       Date Order is Shipped: This charge includes: Federal Express Charge and any Add On Flowers you may wish in the box.

***Placing last minute orders to be shipped the same day is subject to a surcharge fee of $15.00.