Print this page Aloha Dream Kitchen Order Form (Hawaii-Gourmet-Shopping.com or AlohaDreamKitchen.com) Our mailing address: Lanawiliama, Inc, 1803 Democrat St Suite C, Honolulu HI 96819 Phone: 808-352-8593 (leave a message, mention product numbers you ordered and spell your name; we will email or call within 48 hours) Email: info@hawaii-gourmet-shopping.com Print and fill out this form to fax or mail your order. Keep the third page with our contact information and your notes for your records. First Name: _________________________________ Last Name: _________________________________ Shipping Address: _______________________________ _______________________________ _______________________________ Delivery Phone (required for UPS and internat'l): (_____)______________ Billing Address (if different from above): ____________________________ ____________________________ ____________________________ Phone (if different from above): (_____)___________________ Email (optional): _________________________________________ Credit Card (or, attach your personal check or money order*): __________________________________________ Expiration Date (month/year): ____________ CVV: (last three digits on the back; skip if mailing): _______ Name on card: ________________________________________________ Coupon Code (optional): _________________________ Gift Wrap (add $4.00 per order): ________________ Gift Message (optional, no charge): ___________________________________ _______________________________________________________________________ _______________________________________________________________________ My Order (list item number, current price, and specify flavor; see Hawaii-Gourmet-Shipping.com for availability; use additional page if needed): _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ Shipping Cost (use shipping calculator below shopping cart at Hawaii-Gourmet-Shipping.com): $______________________________ Shipping Method (we may change carrier): ____________________ Order Total: $_________________________ I, the undersigned, authorize Aloha Dream Kitchen to charge my credit card above for the total amount of my order. Signature: ____________________________________________ Date: _________________________ * If mailing personal check or money order, make it payable to Lanawiliama, Inc. Check must be drawn on U.S. bank in USD. Allow ten days to clear. $25 fee will apply to a bounced check. Check returned for insufficient funds may be posted to your account electronically. Please no cash, CODs or postage stamps. For Australia, Canada and Great Britain, the only payment method accepted is international money order obtained at your local post office. ----------------------------------------------------------------------- Approximate shipping rates (use shipping calculator at Hawaii-Gourmet-Shipping.com, below shopping cart). Add weight of packaging (a bag of coffee or bottle of 3 oz. perfume is 0.9 lb. each with packaging; two boxes of chocolate - 1.9 lb.). Example below is for 3 items in your order. Add sales tax if shipping to Hawaii zip code: multiply total amount including shipping by 0.0471. _______________________________________________________________________ Shipping Option/: For 0.7 lb. : : : Shipping & : Package : 1 lb. : 2 lb. : 3 lb. Handling Fee : (depends on : : : : zip code) : : : _______________________________________________________________________ UPS Ground : $11.23 : $11.41 : $12.84 : $13.95 : ($13.91 for : ($14.06 for : ($15.38 for : ($16.38 for : rural area) : rural area) : rural area) : rural area) : : : : _______________________________________________________________________ First Class U.S.: $8.04 : $9.30 : $13.50 : $17.70 (no perfumes) : : : : _______________________________________________________________________ Parcel Post U.S.: $7.05 : $9.05 : $12.55 : $14.95 (for perfumes, : : : : 3 weeks) : : : : _______________________________________________________________________ Ship to Hawaii : $5.70 : $5.70 : $6.85 : $7.85 (HI zip code) : : : : _______________________________________________________________________ 2nd Day Air U.S.: $67.69 : $68.59 : $74.40 : $80.86 (no perfumes) : : : : _______________________________________________________________________ Express Mail U.S. $45.65 : $49.70 : $54.25 : $60.90 (no perfumes) : : : : _______________________________________________________________________ International : $45.18 : $46.45 : $50.70 : $54.95 (Canada) : : : : __________________________________________________________________ International : $50.60 : $52.20 : $57.55 : S62.90 (Japan) : : _______________________________________________________________________ International : S55.43 : $57.20 : $63.10 : $69.00 (Australia, : : : : New Zealand) : : : : _______________________________________________________________________ International : S50.49 : $52.20 : $57.90 : $63.60 (Austria, : : : : Denmark, France,: : : : Germany, : : : : Iceland, : : : : Netherlands, : : : : Norway, Sweden, : : : : Switzerland) : : : : _______________________________________________________________________ International : S57.14 : $58.95 : $65.00 : $71.05 (Ireland, : : : : United Kingdom : : : : (Britain, : : : : Northern : : : : Ireland, : : : : Scotland, Wales)) : : : _______________________________________________________________________ International : S56.03 : $57.80 : $63.70 : $69.60 (most other : : : : countries) : : : : _______________________________________________________________________ Our mailing address: Lanawiliama, Inc, 1803 Democrat St Suite C, Honolulu HI 96819 Phone: 808-352-8593 (leave a message, mention product numbers and spell your name; we will email or call within 48 hours) Email: info@hawaii-gourmet-shopping.com Hawaii-Gourmet-Shopping.com or AlohaDreamKitchen.com Copyright 2001-2017 Lanawiliama, Inc. 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