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 2 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)

X

6

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

X

2

Spreaders
(set of 4)

X

4

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: Nutella® Boutique Offer, P.O. Box 359 Whitehouse, NJ 08888.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.

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SAMPLE 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 2 proofs-of-purchase (Gold Seal)*

Spreaders

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

Item

Quantity

Proofs
Per Item

Total
Proofs

Cappuccino Mugs
(set of 2)

2

X

6

12

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

1

X

2

2

Spreaders
(set of 4)

1

X

4

4

Total    

    18

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: Nutella® Boutique Offer, P.O. Box 359 Whitehouse, NJ 08888.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.