Kyle LeBlanc Crawfish Farms
302 St. Peter St. · Raceland, LA 70394
Phone: 985-226-6444 · Fax: 985-537-4658
SECURE ONLINE ORDER FORM
First and Last Name of Person Placing order
Fill out either Airport or Door Delivery (via Fedex Prioirty Overnight) below:
Airport: Enter 3 letter airport code and/or city, state along with name of person picking up.
OR:
Door delivery: Enter delivery Name, Address, City, State and Zip code.
Phone Numbers:
Email Address:
IMPT: If no confirmation email received within 8 hours
(weekend orders will receive confirmation on Monday morning) call 985-226-4942.
Date to Receive Products (the day before your boil):
(If more lines are needed for your order, you can write them in comments below, or send an email to kyle@crawdads.net with additional information).
ORDER
*Do not fill in shipping charges if you want them charged to your Fedex account, or if
you are shipping to airport (you will pay airport shipping charges upon pickup directly to the
airline). Use chart (click here) for shipping charges. When using your FedEx account, charges
will be according to the rate agreement that you have with FedEx and will not be the charges
shown on our chart.
If you want to ship via FedEx or UPS on your account no., provide # here:
WE ARE NOT RESPONSIBLE FOR ANY SERVICE FAILURE LOSS BY ANY SHIPPING COMPANY
PAYMENT INFORMATION
Name exactly as appears on credit card
Phone number associated with credit card
Billing Address
Billing City, State & Zip Code Required
MasterCard VISA Discover American Express
Card Number
Expiration Date
Security Code
What is the security code? (see below)
MasterCard/Visa/Discover security code is the last 3 numbers on the reverse of your card.
American Express security code is the 4 small numbers printed just above your account no.
on the front of the card.
Comments, if any.
NOTE: CANCELLATION or CHANGES of any order must be made in writing the day before shipping
with receipt of your message confirmed by us.
Once you press the submit button, you will see a summary of your order listed; please print this out for your record.
Check to be added to update list. If you are currently getting updates, no need to check. We don't email every time there is a price change; just reminders before special times, approx. 4-6 times a year.
By clicking the "SUBMIT" button, cardholder named above agrees to pay all shipping charges associated with this order as stated in this order , whether the shipping is charged to your Fedex/UPS/Airline account, charged by us or charged by the airline upon pick up. Cardholder also agrees to pay any and all unpaid, reversed or returned charges with the credit card number provided on this order form.