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 Add 4% Sales Tax:
		Total Due:

POSTAGE CHART
$0.00-$50.00..........$5.50
$50.01-$100.00........$6.50
$100.01-$150.00........$7.50
$150.01-$200.00......$8.50
$200.01-$250.00....$10.50
$250.01-$300.00....$12.50
$300.01-$400.00....$14.50
over $400.00.............$16.50

Credit Card Information:
Card Name: Card Number:
Exp. Date: Name on Card: Signature:____________________________________
Signature required for credit card orders only.

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