Order Form

lalogotransp1.gif (3045 bytes) Means Breastfeeding Support!™1971-2009

ORDER FORM Jan 2009
Print this Order Form, to phone, fax or mail your order, or

You can send this page as an email. See instructions below.
1. Browse our Catalog to see items & Prices
2. Complete the Order Form.
3. Submit your order. Simple!
See Ordering Instructions below

   Toll-Free Ordering &
            LA Consulting in USA
         1.866.866.1239
       Callers outside USA
              1.423.744.9090
    FAX 1.423.744.9116

Item Number	Description	PRICE	QTY	AMOUNT







__ I'm ordering a Cooler. If my 1st Choice above is not available, my 2nd Choice color is:		ORDER TOTAL		$
ONLY Tennessee residents add sales tax on Order Total.		Tenn. Sales Tax 7%		$
Every order includes Handling Fee of $5.95 for UPS (or $7.00 if shipping via Mail.)		Handling Fee		$ 5.95
Ship Via:		Shipping Fee		$
Ship Via:		GRAND TOTAL		$

Handling & Shipping Rates Chart as of January 1, 2009
Handling Fee Applies to all UPS orders. $ 5.95 or $7.00 for Mail Orders	UPS Ground Orders $60 + FREE !	UPS Ground Orders - $60 $ 8.25 2 Lbs. Rate* $9.25	UPS 3-Day Select $16.00 2 Lbs. Rate* $17.85	UPS 2-Day Air $18.00 2 Lbs. Rate* $22.50	UPS 1-Day Air $38.00 2 Lbs. Rate* $42.75
	Alaska, Hawaii, Puerto Rico, use Mail:	Priority Mail Ins. + Del Confirmation $10.60	Priority Mail Ins. + Del Confirmation 2 Lbs. Rate* $13.65	Express Mail Ins. + Del Confirmation up to 2 Lbs. $23.50	Express Mail Ins. + Del Confirmation over 2 Lbs. $26.75

Handling Fee of $5.95 per order is already filled in for you on the Order Form.
Find the shipping service you want, UPS Ground, UPS 3-Day Select, etc., Add it to your Order.
Your Grand Total will include: Items Ordered, + Handling, + Shipping.

* Weight Estimates: 1 LA Deluxe, or LA Standard, or Rolls 4-Pack, = 1 Lb. Rate.
LA Deluxe + Rolls 4-Pack, or a LA Rolls 6-Pack, or LA Rolls 12 Pack = 2 LB Rates.

Shipping Rates are for USA .
Free UPS Ground Service for orders $60 and over!: Estimated Delivery Time 1- 2 days TN & adjacent states. 3-4 days Eastern, Central & Mountain states.
5-6 days West Coast States. Allow extra days for weekends or holidays.
Shipping via US Mail: See chart above for rates.: Note: Alaska, Hawaii, Puerto Rico: Shipped via US MAIL only.
RUSH Orders: If you need UPS 1- or 2-Day Air or 3-day Select, phone or FAX your order to expedite shipping.
Confirmation & UPS Tracking: Include your e-mail to receive confirmation & UPS Tracking Number.
International Orders: We ship worldwide. Request an Estimate of International Shipping Rates before ordering.

LA 30-Day Returns/Refunds Policies:

Call to obtain a Return Authorization. (RA Number).
Only unopened LA Systems and supplies are returnable for a refund.
Returns are subject to 20% restocking fee.
Returns must be made within 30 days after purchase.
Ship/Handling Fees are not refundable.
Customer pays shipping to return items. COD returns will be refused.

Credit Card Billing Address & Payment Information:
Payment Method: Check one. __ Credit Card __ I'll phone Credit Card __Credit Card is on file __Check/Money Order enclosed
Credit Card: __ VISA __ MASTERCARD __ DISCOVER __ AMERICAN EXPRESS Verification code:_________ REQUIRED
Card No.:		Expiration Date:
Signature:		Phone - Home
Name		Phone - Work
Address		Phone - Cell
Address		.
City:	State:	Zip Code:
NOTE: Address above should match your Credit Card Billing Address, If credit card address above is a PO Box or rural route, provide street address here for Credit Card Verification..
Email Include your e-mail to receive confirmation & UPS Tracking Number.

Shipping Information: if different from Credit Card Address / Payment Information.
Ship to: A Street Address is required for UPS delivery	Phone
Name	.
Street	.
City:	State
Zip Code:	State

Survey: Please check all that apply. This will help us improve our services.
I heard about Lact-Aid System from:			My breastfeeding situation is:
O Article O Lact. Consultant O Midwife	O Doctor O Nurse O Friend	O Book O WWW search O Email List	O Slow Wt. Gain O Low milk supply O Suck/Latch Problem	O Preemie O Cleft Lip / Palate O Breast Surgery	O Working. O Relactation O Adopt O Surrogacy
O Other			O Other

To Top of Order Form

Ordering Instructions
To Order by Phone, Fax, or Mail:

Print this Order Form.
Browse our Catalog to select items & see Prices. Fill out Items section
Complete filling out Order Form. Fill out Credit Card/Payment Section.. Fill out Shipping Section.,
Submit your order: Use it for reference to phone your order. Order Toll-Free in USA.
or .... Fax or mail pages 1 -3 to Lact-Aid. See phone numbers and addresses below.

To Order by Email with the above Order Form:
We do not have an interactive shopping cart, but you can easily use the Order Form to submit your order via email.

On your web browser, select PAGE
Then select SEND PAGE BY EMAIL. The Order Form will open in a new message.
On your email, type in the necessary information.
Then click SEND to submit your email order. Include a phone number so we can contact you if there are any questions.
For greater security, you can send your credit expiry date and verification number on a separate email.

To Order by Regular Email Letter:

You may also email an order to us if your card information is ALREADY ON FILE at Lact-Aid. Or,
if you prefer, you may email an order to us, then phone or fax the credit card data to us. We are not set up for secure online transactions. On your email message, describe the items and quantity you want and method to ship.
Always include a daytime phone number in case we have questions about your order.
RUSH Service: If you need your order sent via UPS 1-day AIR, UPS 2-day Air, or UPS 3-Day Select ... we recommend phoning your order to expedite processing. See Order Form for rates and estimated delivery times.
International Orders - For orders outside the USA, see our International Orders Page and request an Estimate of International Shipping before ordering.

1.866.866.1239 Toll-Free Ordering and LA Info and Consulting - in USA.
1.423.744.9090 for Callers outside USA.
Lact-Aid International, Inc. PO Box 1066, Athens TN 37371-1066 USA
Send email to:    orders @    (This address is shown with spaces to prevent spam search engines from picking up the email address. When you fill in the email address, eliminate the spaces.)
FAX    1.423.744.9116