Order Form

Nutella® Spread Merchandise Order Form

Cappuccino Mugs

Available with 6 proofs-of-purchase (Gold Seal)*

Heavyweight T-Shirt
Please be sure to choose a size if ordering a t-shirt

Available with 3 proofs-of-purchase (Gold Seal)*

Spreaders

Available with 4 proofs-of-purchase (Gold Seal)*

See sample order form

Item

Quantity

Proofs
Per Item

Total
Proofs

Cappuccino Mugs
(set of 2)

Heavyweight T-Shirt (1)
Please circle a size:
M L XL

Spreaders
(set of 3)

Total

Shipping Address (please print)

Name:____________________________________________
Address:___________________________________________
City:____________________________	State:____________________
ZIP: ____________________________	Phone: ___________________
E-mail Address:____________________________________

Please fill out this form and return with proof(s)-of-purchase *(Gold Seal under cap) to: CMS Fulfillment Center, Program ID: NUTELLA08, PO Box 426008, Del Rio, TX 78842-6008. Offer good only in the USA, while supplies last. Order forms with insufficient information or orders containing insufficient proofs will be returned. Duplicate or invalid requests, or proof-of-purchase other than the gold seal will be rejected and proof-of-purchase will not be returned. Please allow 6-8 weeks for delivery. Not responsible for lost, damaged, postage-due or misdirected mail. Void where prohibited, taxed, or otherwise restricted.

SAMPLE ORDER FORM