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BLUE QUAIL WINE ORDER FORM for 2015
WINE
2014 Blue Quail Chardonnay
2014 Blue Quail Sauvignon Blanc
2014 Blue Quail Pinot Gris
2013 Blue Quail Pinot Noir
2013 Blue Quail Old Vine Zinfandel
# of Bottles Price Per Bottle
x $14.99 each
x $14.99 each
x $14.99 each
x $18.99 each
x $18.99 each
WINE COST
$
$
$
$
$
TOTAL NUMBER OF BOTTLES
TOTAL WINE COST
$
SALES TAX
Enter your local sales tax rate
(State, County & City combined)
Using your tax rate
enter tax on
% Total Wine Cost $
SHIPPING
If total number of bottles is 1-4 add $20
If total number of bottles is 5 or 6 add $25
If total number of bottles is 7-12 add $30
If total number of bottles is 13 or more add $35
$
ORDER TOTAL
SHIPPING INFORMATION
Name
Bus. Name
Street Address
City
Email
CREDIT CARD INDORMATION
Name on Card
Credit Card Number
Expiration Date
State
Phone
Zip
CVV
By signing this order form, I attest that I am 21 years of age or older
and that I may legally purchase wine, ands that it is legal to ship wine
to me where I have asked you to.
SIGNATURE
DATE
Print this order form, fill it our completely, and fax it to Blue Quail
for fulfillment. The fax number is (707) 743-1126. Thank you!
S