A Gourmet Cajun Shop, LLC fax order form: spicy gourmet cajun and new orleans foods, seasonings & spices. Great food from south louisiana!

Cajun Shop Crawfish & Alligator Banner Image (6995 bytes)


Fax Form

Print screen, fill out & Fax us your order. Our Fax No is: 1-225-313-6303  

Ship To Information...
Name: Address:
City: State: Zip Code:
Fax: Email: Phone:

Credit Card Information...
Full Name on Card: Card Type (Circle):  Visa  MC  Amex
Credit Card No:
Expiration Date (mm/yy): Card Security Code:

Bill To Address (if different from above)..
Name: Address:
City: State: Zip Code:
Fax: Email: Phone:

Items Ordered...
. Price Quantity Total Price
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Louisiana Sales Tax: For Louisiana Customers Only (9.0%):

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Total Order:

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Our shipping costs are the based on UPS shipping rates displayed at www.ups.com.
Please select your UPS shipping choice:   Ground  _    2nd Day Air  _    Next Day Air  _
If you'd like us to hold your order until you approve shipping costs, please check here  _