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To order by fax­-print out orderform, fill out and fax (570) -837-9834
To order by phone­-print out orderform, fill out and call (570) -837-3703
We can only ship within the state of Pennsylvania. You must be 21 to order or receive wines
CUSTOMER INFORMATION:
Name:
  
Address:
City:
     State:     Zip:
Phone:
  
Email:
  

SHIPPING ADDRESS:
Name:
  
Address:
City:
     State:     Zip:
Phone:
  
Gift Message:

FORM OF PAYMENT:   SHIPPING CHARGES :
VISA Mastercard Check Money Order   • 1-2 bottles = $7.50 • 2 Bottle Gift Box = $7.50*
Expiration Date: Month:    Year:       • 3-4 bottles = $10.00 • 3 Bottle Gift Box = $10.00*
Credit Card #:   • 5-6 bottles = $14.00 • 4 Bottle Gift Box = $12.50*

___________________________________________________________
Signature of Authorized Buyer		   • 6-12 bottles = $22.00    * shipping costs do not include the
      cost of the 2, 3, 4 bottle gift boxes.
      We SHIP FedEx 2Day® SERVICE
An adult Signature is required for delivery.
 
         
Prices do not include 6% sales tax or shipping.
WE OFFER A 10% DISCOUNT ON CASES (12 bottles or more)
You may mix and match 12 bottles of different varieties for case pricing.

 
   

NOTE: If you have filled in the areas above, and wish for the information to be printed,
please print this page before proceeding onto Page 2.