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* print this form out and send in with your payment *
--------------------------------------------------------------- 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 --------------------------------------------------------------- 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 |