* print this form out and send in with your payment *
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Sergio "The Latin Snake" Mora
Merchandise Order Form

 
Name:_____________________________
 
Address:_____________________________________
 
City:______________________________________
 
State:_____ Zip Code:_________ Country:______
 
Telephone:_________________________
 
Email Address:____________________________
 
ITEMS:
 
AUTOGRAPHED 8 X 10 Sergio Mora Pics
$12.00 each USD
 
#1 (face only): Qty._____
 
#2 (face and body): Qty._____
 

WOMENS Sergio Mora Tees
$15.00 each USD
*please specify quantity & size for each shirt
 
Sizes Available: M - L - XL
 
SM Logo - Red Sleeves, White Shirt:
Qty._____ Size(s):________
 
SM Logo Grey Sleeves, White Shirt:
Qty._____ Size(s):________
 
SM Logo Black Shirt, Red Trim:
Qty._____ Size(s):________
 

MENS Sergio Mora Tees
$15.00 each USD
*please specify quantity & size for each shirt
 
Sizes Available: M - L - XL - 2XL - 3XL
 
SM/Snake Logo (WHITE):
Qty._____ Size(s):________
 
SM/Snake Logo (BLACK):
Qty._____ Size(s):________
 
 
SUBTOTAL: ____________
 
Shipping/Handling in U.S. -
Add $5
 
S/H OUTSIDE U.S. - Get Rates From USPS.COM
 
TOTAL DUE: _______________
 
 
Method of Payment:
(payable to LATIN SNAKE PROMOTIONS)
 
Money Order
ONLY
 
Countries outside USA must send U.S. Bank Approved Money Order ONLY.
(No personal checks)
 
Send to:
LATIN SNAKE PROMOTIONS
1301 W. Olympic Blvd
Montebello, CA 90640

 
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PLEASE ALLOW 2 - 4 WEEKS FOR DELIVERY
 
NOTE: Due to a number of bounced checks, ALL orders must be paid using a U.S. Money Order.
CHECKS NOT ACCEPTED