LaCroixTees.com
Pay-By-Mail Form

Name _____________________________________

Address______________________________________

_____________________________________________

_____________________________________________

Phone Number ________________________________

eMail Address:

 __________________________________________

  Send Cashier's Check, Bank Check, Money Order, Cash
or International Money Order (payable in US funds)

Payable to:

LaCroix Enterprises
PO Box 968
Newport OR 97365

Please Print Out This Form and Include with Payment.
(Ctrl-P will print this page)

BE SURE TO INCLUDE PRINTED
COPY OF YOUR SHOPPING CART!
(If you don't... we won't know what to send you.)