Print this form and mail to Louisiana Lagniappe -Please print names legibly
If you want a pink, gold, or green color name tag please note by your name.
|
Louisiana Lagniappe
104 General Lee Drive Hahnville, LA 70057 |
www.lalagniappe.com sales @lalagniappe.com985-308-0551 |
|
Red Hatter’s Name |
Name(s) on Nametag (please print legibly) |
Pink or Red |
Cost: $6.95 - no name $7.95 - 1 name $8.95 - 2 names $9.95 - 3 names $10.95 - 4 names |
|
| 1 | ||||
| 2 | ||||
| 3 | ||||
| 4 | ||||
| 5 | ||||
| 6 | ||||
| 7 | ||||
| 8 | ||||
| 9 | ||||
| 10 | ||||
| 11 | ||||
| 12 | ||||
| 13 | ||||
| 14 | ||||
| Ship |
Cost based on weight
1-5 name tags - $4.85 shipping 6-10 name tags - $6.95 shipping 11-15 name tags - $8.55 shipping 15+ - $10.55 shipping |
Shipped via Priority Mail | ||
|
|
Total |
| Ship To Address | Billing Information |
| Name |
5 Check Enclosed (Make checks to Louisiana Lagniappe) |
|
Address |
5 Pay by CC - circle one - V, M, Amex, Discover |
| City |
Name on Credit Card (exact) |
| State & Zip | Credit Card Billing Address |
| Phone |
City |
| State, Zip | |
| comments | Credit Card Number |
| Credit Card Expiration Date |