Kyle LeBlanc Crawfish Farms

302 St. Peter St. Raceland, LA 70394

Phone: 985-226-6444 Fax: 985-537-4658 

 

 

SECURE ORDER FORM

 

For same day orders, please call first, 985-226-6444.

 

(HIT TAB KEY TO GO TO THE NEXT FIELD; HITTING "ENTER" KEY WILL SUBMIT THE FORM)

 

Name

 

Delivery Address (for airport shipments, type in name or city of airport)

 

Delivery City, State and Zip Code (for airport shipments, type in airport code if you know it; otherwise, just type in city)

 

Is delivery address a business (do not answer for airport delivery): 

 

Phone Numbers:

 

Email Address:  NOTE - PLEASE READ:  We email confirmation of receipt of your order within 24 hours (longer on weekends). If you do not receive an email or have trouble filing out form, please call Donna at 985-226-4942. 

 

Date to Receive Products: 

 

(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

 

QUANTITY

PRODUCT DESCRIPTION

PRICE PER LB.

TOTAL AMOUNT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*Shipping Charges:

 

 

 

TOTAL 

 

*Do not fill in shipping charges if you want them charged to your Fedex or UPS 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. 

 

Charge shipping to my Federal Express Account no.

 

Charge shipping to my UPS Account no.   

Zip code associated with UPS Account No. (This MUST be filled in ONLY if using your UPS Account No.)

 

 

PAYMENT INFORMATION

 

Name exactly as appears on credit card

 

Phone number associated with credit card

 

Billing Address

 

Billing City, State & Zip Code

 

 

MasterCard       VISA     Discover

(MasterCard, Visa or Discover preferred)

 

 American Express (An extra charge of $.10/lb. will be added to your order if paid with 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

 

 

Once you press the submit button, you will see a summary of your order listed; please print this out for your record. NOTE - PLEASE READ:   We email confirmation of receipt of your order within 24 hours (longer on weekends). If you do not receive an email or have trouble filling out form, please call Donna at 985-226-4942.

 

Check this box if you wish to receive email updates on prices throughout the year.  We don't email every time there is a price change, but we do keep you informed mostly in Spring and Summer.