Shipping Form by lmJTcd8

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									                            Aloha Ash Scattering
                                     Shipping Form
              Please print, fill out, and include in the shipping of the ashes.

Required Information
Name of Contact:

________________________________________________________________________
Date of Shipment:

________________________________________________________________________
Mailing Address:

________________________________________________________________________
E-Mail Address:
________________________________________________________________________
Phone:
________________________________________________________________________

Service Information
Please check which service you are seeking:

__$249 Unattended Ocean Ash Scattering with E-mail Memorial Package

__$269 Unattended Ocean Ash Scattering with Priority Mail Memorial Package

__$249 Unattended Mountain Ash Scattering with E-mail Memorial Package

__$269 Unattended Mountain Ash Scattering with Priority Mail Memorial Package

_____ Custom Attended Ash Scattering with details discussed prior.

Payment Information
Please check appropriate line.
__ PayPal payment through website
__ Credit card payment over the phone
__ Money Order included in shipment. Please make Money Order payable to Aloha Ash
Scattering. Sorry, no personal checks are accepted.




                                  P.O. Box 424, Kula, HI 96790
              Toll Free Voice Message: 877-563-9053 Island Direct: 808-633-1450
              Website: alohaashscattering.com E-Mail: info@alohaashscattering.com

								
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