Needlepoint, etc. Order Form

1040 South King Street, Suite 103
Honolulu, HI 96814
Telephone: 808-591-0377
Fax: 808-591-0477

Order Form

Instructions: This order form can be printed and then mailed or faxed to Needlepoint, etc. We do not offer online ordering at this time.

*Additional colors/information may be added in the comments box below.

Sal: First Name: Last Name:
Street:
City: State: Zip: Country:
PM Phone E-Mail

Item#	Item Name/Color*	Qty.	Price Each	Total Price








Comments/Additional Information/Instructions/Shipping Instructions: Please add my name to your mailing list.		Subtotal:
		Postage:
		**HI Residents Oahu Residents Add 4.712% Sales Tax: Neighbor Island Residents Add 4.172% Sales Tax:
		Total Due:

POSTAGE CHART
$0.00-$50.00..........$6.00
$50.01-$100.00.......$7.00
$100.01-$150.00.....$8.00
$150.01-$200.00.....$9.00
$200.01-$250.00...$11.00
$250.01-$300.00...$12.00
over $300.00........$15.00

Credit Card Information:
Card Name: Card Number:
Exp. Date: CVV Code (on back of CC)

Name on Card: Signature:____________________________________
Signature required for credit card orders only.

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