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Daisy Creek Wine Order Form |
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Print and complete the below form in full and mail with check or money order to the address below. All wine is shipped UPS Ground and billed to you at our direct cost. All case orders (whole or mixed) include a 10% discount, 2 or more cases include a 15% discount.
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Bottle Price: |
Case Price: |
# of Bottles: |
# of Cases: |
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2006 Viognier |
$20.00 |
$216.00 |
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2005 Syrah |
$18.00 |
$194.40 |
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2003 Merlot |
$18.00 |
$194.40 |
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Buyer's Information (please complete in full) |
Shipping Information (if different from buyer's info) |
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Full Name: |
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Full Name: |
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Company: |
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Company: |
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Address: |
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Address: |
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City: |
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City: |
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State: |
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State: |
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Zip Code: |
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Zip Code: |
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Tel: |
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Tel: |
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E-Mail: |
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E-Mail: |
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Mail to: Daisy Creek Vineyard • 675 Shafer Lane • Jacksonville, OR 97530 |
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