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Please Fill In Fields Below:
TOTAL
QTY PRICE EA.
PRODUCT/DESCRIPTION
SUB-TOTAL
Shipping & Handling Charges:

Flat Fee of $9.00
Parcels Shipped Via USPS
United States Priority Shipping
SHIPPING & HANDLING
Hawaii Residents Add 4% Tax
GRAND TOTAL:
PAYMENT METHOD:
Visa/Mastercard
Personal Check Money Order/Cashiers Check
Bill To: (Field in Red are required)
Last Name:
First Name:
Address:
Apt#:
City:
State:
Zipcode:
Phone#:
Email:
Exp Date:
Visa/Mastercard#:
Personal Check/Money Order or Cashier's Check please make check payable to:
Solitude Spa
Mail To:
Solitude Spa
P.O. Box 61592
Honolulu, Hawaii 96839

PHONE ORDERS please call:
808-368-1398
Ship To: (If the same as billing leave blank)
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Address:
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