La Louisianne Order Form

Please print this order form, fill in required information and mail to address below.
Unit Total
Qty Cat. No. Item Description Price Price
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Cassettes .. $4.00 SUBTOTAL: _________
CDs ....... $15.00 Louisiana Customers add 4% Tax: _________
Albums ..... $3.00 All US orders shipped via Parcel Post - Shipping & Handling: $3.75
============== TOTAL: _________
If additional space on order form is required, please list additional titles on back of form. FOREIGN ORDERS - please use Visa / MC for payment and specify United Parcel Service (UPS) or air parcel - shipping charges will be added to your bill. U.S. ORDERS - If you do not wish to pay by credit card, you may also send check or money order made payable to:
La Louisianne Records
P.O. Box 52131
Lafayette, LA 70505-2131

Ship To
Name:__________________________________________________________________________

 Address:________________________________________________________________________

 City:_____________________________________State:______Zip_________________________
 
 

VISA / MC # _________________________________________________Exp Date_________Signature__________________________________