Kyle LeBlanc Crawfish Farms
302 St. Peter St. ·
Raceland, LA 70394
· Fax: 985-537-4658
ONLINE ORDER FORM
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.
Door delivery: Enter delivery Name,
Address, City, State and Zip code.
IMPT: If no confirmation email received within 8 hours
receive confirmation on Monday morning) call 985-226-4942.
Date to Receive
Products (the day before your boil):
more lines are needed for your order, you can write them in comments
below, or send an email to email@example.com
with additional information).
in shipping charges if you want them charged to your Fedex
account, or if
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,
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:
ARE NOT RESPONSIBLE FOR ANY SERVICE FAILURE LOSS BY ANY SHIPPING COMPANY
Name exactly as
Billing City, State
Zip Code Required
Discover American Express
What is the
security code? (see below)
security code is the last 3 numbers on the reverse of your card.
is the 4 small numbers printed just above your account no.
on the front of the
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.
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.