Loz's Leisure Merch Pre-Order Form

Loz's Leisure Merch Pre-Order Form
** This is a pre-order form. You agree to pay within a week of submitting this form, your order will be cancelled if not. We'll be announcing the release date of the shirts and orders will be shipped 1-2 days after that.

** 50php from each order will go to the Haribon Foundation (www.haribon.org.ph).

All billing and instructions will be directly emailed to the email address you enter below.

Thank you!
Name*

First NameLast Name
Address*

Street Address

Street Address

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Order Info*
Color - Size - Quantity
Mode of Payment*

PayPalBPI Bank TransferLBCPalawan Express
Should be Empty: