Customer Name                                          Phone

Fax                                                                  .E' mail

Address

Credit Card Please enter your Credit Card Info in this field if you feel that is safe with our Website or you could submit this form with your mailing Info only then phone in your Card Info. Mahalo! ( sorry no DISCOVER CARD ) Note: We can't process the card w/o last 3 digit (back of card and near your signature )

Example: Card No 4817-0006-2846-5000   334 on the back of your Visa or Master Cards.

Phone in Card Info                                         submit Card Info with Order Form 

Recipient Name

Phone

Address

Message

Ship Out Date                         

 Lei will be use on

Note: No shipment go out on SATURDAYS & SUNDAYS and FRIDAYS ship out only apply to

 the following states: AZ, CA, CO, UT, WA, OR, NV. ( not available in all areas )

FEDERAL EXPRESS CHARGE $10.00 EXTRA FOR SATURDAY DELIVERY  ( Lei warranty voided )

FEDERAL EXPRESS GUARANTEED TO DELIVER YOUR PACKAGE WITH 1 TO 2 DAY AT ANY WHERE IN U.S.A.

Click here to authorize FED EXP to delivery your package with out obtain SIGNATURE.

DECLARE VALUE     ( please select the correct value field )

Declare Value $100                       Extra Charge $0.00 Declare Value $101 to $500              Extra Charge $3.00 Declare Value $500 to $1000               Extra Charge $0.50 per $100 of value

Click here to confirm that you have been review and agreed The Shipping Policy.

Note: Your shipment may not send out on time if this button has not been checked!

Click here to confirm that a Lei Order Quotation is needed prior the order to be ship.

Please select your Lei order option.      1, Proceed the substitution if it is necessary. 2, Cancel the Item if a substitution is occur. 3, Cancel my entire order.

SHIPPING CHARGE

PACKING & BOX $6.00 ( This fee will waived if you place the order ONLINE )

SHIPPING POLICY                                  E' Mail aloha@flowerleis.net