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HONOLULU BABIES MAIL ORDER FORM
To Print Form: Right click mouse anywhere on form and select print from menu options
Item NameItem NumberQuantityPrice
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Shipping & handling based on the Item Total Cost:
Up to $25.00 = Add $6.95
$25.01 - $45.00 = Add $9.95
$45.01 - $75.00 = Add $11.95
$75.00 - Over = Add $14.95
Item Total Cost:.
Shipping/Handling:.
Total Order Cost:.
BILLING INFORMATION
First Name: ________________________________ Last Name: ____________________________________
Street Address: ____________________________________________________________________________
City: _____________________________________________ State: _________________________________
Zip Code: _________________________ Phone Number: ________________________________
Email Address: _____________________________________________________________________
SHIPPING INFORMATION
Is The Shipping Address The Same As The Billing Address? .........Yes ....... No
If No, Please Fill In The Following Information:
First Name: ________________________________ Last Name: _____________________________________
Street Address: ____________________________________________________________________________
City: _____________________________________________ State: _________________________________
Zip Code: _________________________
Would you like to include a gift card? If yes, please fill in your greeting:
__________________________________________________________________________________________
How did you find my website?__________________________________________________________________
This completed form approved by: __________________________________________________________
Your signature: ____________________________________________ Today's Date: _______________

Please mail this form and a check or money order to:

Honolulu Babies
P.O. Box 44394
Kamuela, HI 96743