Wine Club Order Form
Members of the Udderly Different Wine Club may use this form to conveniently arrange shipping of wine either to them selves or to others. We can use your shipping information already on file or you the information you provide below.
| Please Ship To My Address On File |
||
| Please Ship To The Address Below |
| Name | |||||
| Address | |||||
| City | State | Zip | |||
| Evening Phone | |||||
| Daytime (mobile) Phone | |||||
| Email Address | |||||
| Ship On Next Available Shipping Day |
|||||
| Delay Ship (Send At Later Date) | |||||
| Week of Required Delivery (date) | |||||
Payment Method:
| Please Bill My Wine Club Card |
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| Please Contact Me For Alternite Payment Method |
Available Wines:
| Vintage | Product | Qty | |
|---|---|---|---|
| Current Releases | |||
| 2009 | Muscat | ||
| 2007 | Pinot Noir Kelsey | ||
| 2007 | Pinot Noir Sophie |
||
| 2007 | Gabriela | ||
| 2007 | Tempranillo Reserve | ||
| 2008 | Primitivo Reserve | ||
| Library Wines | |||
| 2008 | Siegerebe | ||
| 2008 | Muscat | ||
| 2006 | Durif Reserve | ||
| Merchandise (May be shipped separately from wine purchase due to size and breakage) |
|||
| Stemless Wine Glasses | |||
| M | T-Shirts (Hanes Tagless) | ||
| L | T-Shirts (Hanes Tagless) | ||
| XL | T-Shirts (Hanes Tagless) | ||
| XXL | T-Shirts (Hanes Tagless) | ||
One of the PCV staff will contact you with your total price and the cost of shipping once your order has been received. Thank you.
