Easter Seals Hawaii
HOLIDAY
GIFT BASKET
FUNDRAISER
Gifts that make a difference
Proceeds benefit Easter Seals Hawaii programs
for people with disabilities and special needs.
$100.00 HOLIDAY BASKET
($50.00 Tax Deductible Donation)
Products by Big Island Delights include:
 Macadamia Nut Party Mix 8 oz.
 Energy Bar 3.75 oz.
 Chocolate Chip Macadamia Nut 4.5 oz.
 Hawaiian Macadamia Nut Granola 8 oz.
 Passion Fruit Shortbread Box 4.5 oz.
 Macadamia Nut Shortbread 4.5 oz.
 Furikake Party Mix 8 oz.
 Chocolate Chocolate Biscotti 5 oz.
 Assorted Chocolate Dipped Macadamia Nut
Shortbread Box of 12, 10 oz.
 Mango Shortbread Box 4.5 oz
Also included:
 Pack of 5 Stationary Cards designed by Easter
Seals Hawaii Participants
 Easter Seals Hawaii Thermal Tote Bag
Deadline to order is MONDAY, NOVEMBER 14, 2016
You can make a difference
Proceeds from this fundraiser will deliver life changing programs and services.
Easter Seals Hawaii offers exceptional, individualized, family-centered services
to empower people with disabilities
or special needs to achieve their goals
and live independent, fulfilling lives.
Order Form
Deadline to order: MONDAY, NOVEMBER 14, 2016
Purchaser’s Info
Name__________________________________________________________________________________
Address____________________________________________ City______________________ State______
Zip Code______________________ Email Address ______________________________________________
Phone Number___________________________________________________________________________
Options
Pick-up – All baskets will include a blank gift tag.
Free delivery to 1 location, on purchases of 10 baskets or more to (Restrictions may apply). Delivery will be made by
December 21st.
Total Baskets
________ x $100.00 = $___________
Shipped* - Ship to recipient(s) in Hawaii or the U.S. Mainland by FedEx. All baskets will include a message (please
check off which message you prefer on order sheet below) on a gift tag. Basket(s) will be shipped out by Friday,
December 16, 2016.
Total Baskets w/Local Shipping Fee*
Total baskets w/ U.S. Mainland Shipping Fee
________ x $110.00 = $____________
________ x $120.00 = $____________
Subtotal ____________
$____________
Donation I would like to show my support with a donation.
Total
All Sales are final.
$____________
* Delivery information is required to complete your order.
Payment
Visa
American Express
Master Card
Discover
Check
Name on Credit Card________________________________________________________________________
Credit Card # ______________________________________________________________________________
Expiration Date ___________________________
Security Code_____________________________
Authorized Signature ________________________________________________________________________
Please contact Shandis Ching for more
information or to order baskets.
[email protected] or 528-1708
Delivery Information
Shipped Basket Information
Sender’s Name:
Recipient’s Name:
Recipient’s Address:
State:
City:
Message (Choose One):
You are appreciated!
Happy Holidays!
Zip Code:
Merry Christmas & Happy New Year!
All the best this Holiday Season!
Other (Limit 40 Characters) ________________________________________________________
Shipped Basket Information
Sender’s Name:
Recipient’s Name:
Recipient’s Address:
State:
City:
Message (Choose One):
You are appreciated!
Happy Holidays!
Zip Code:
Merry Christmas & Happy New Year!
All the best this Holiday Season!
Other (Limit 40 Characters) ________________________________________________________
Shipped Basket Information
Sender’s Name:
Recipient’s Name:
Recipient’s Address:
State:
City:
Message (Choose One):
You are appreciated!
Happy Holidays!
Zip Code:
Merry Christmas & Happy New Year!
All the best this Holiday Season!
Other (Limit 40 Characters) ________________________________________________________
Shipped Basket Information
Sender’s Name:
Recipient’s Name:
Recipient’s Address:
State:
City:
Message (Choose One):
You are appreciated!
Happy Holidays!
Zip Code:
Merry Christmas & Happy New Year!
All the best this Holiday Season!
Other (Limit 40 Characters) ________________________________________________________
Please mail the completed order form with payment to:
Easter Seals Hawaii
710 Green St.
Honolulu, HI 96813
Please feel free to copy this page as needed.