wine order form

ORDER FORM • Phone, Fax or Mail 1. Type in your order and information. 2. Print form. 3. Sign, and mail or fax to River Road Vineyards along with payment. We also accept phone orders.
PHONE: 707-887-8130 or Fax: 707-887-8160
MAIL: River Road Vineyards, 5220 Ross Road, Sebastopol, CA 95472

*You must be 21 or older to purchase wine. Wine must be delivered to an address where an individual of at least 21 years of age is available to sign for wines during regular business hours.
Wine can easily be delivered to a business address.

Orders of 1 case (12 bottles) or more receive 10% discount on wine total.

VARIETY	VINTAGE / APPELLATION	PRICE	# BOTTLE	TOTAL
Chardonnay	2006 Sonoma County	$13.00	x	= $
Chardonnay	2006 Reserve Russian River Valley	$16.00	x	= $
Cabernet Sauvignon	2006 Sonoma County	$14.00	x	= $
Merlot	2005 Sonoma County	$14.00	x	= $
Pinot Meunier	2006 Russian River Valley	$15.00	x	= $
Pinot Noir	2006 Russian River Valley	$18.00	x	= $
Wine Total				= $
Case Discount (see below)				- $
Sub-Total				= $
Sales Tax (California deliveries add 7.75% )				+ $
Add Delivery Costs (see below)				+ $
TOTAL AMOUNT DUE				= $

Case Discount: Take 10% off Wine Total when ordering by the case.12 bottles per case, cases can be mixed.

Shipping Costs:

3 Bottles = $14.00

6 Bottles = $18.00

12 Bottles = $26.00

Ship To:

This address is:
Name:
Street Address:
City & State:
Zip Code:
Phone:
FAX:
E-mail:

Method of Payment:

Payment Method:
If paying by credit card, enter Credit Card #, Security Code, Exp. Date, Name on Credit Card and Billing Address.
Credit Card #:	- - -
Credit Card Security Code:		Code is the last three numbers on back of card.
Exp. Date:
Name on Card:
Street Address:
City & State:
Zip Code:
Phone:
Signature __________________________________ (Please sign here before mailing or faxing) Thank You for Your Order....ENJOY!