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PINUP WINE ORDER FORM

Order online below or print and fax form to: (707) 433-3437
 Mail to: PinUp Wine, P. O. Box 2057, Healdsburg, CA 95448
Or call: (707) 433-3711

Minimum order for shipping is 3 bottles

Price

# Bottles
2011 PinUp Cabaret - Red wine blend
Sonoma County 		37.50 bottle
$450.00 case
2010 PinUp Cabaret - Red wine blend
Sonoma County 		37.50 bottle
$450.00 case
2009 PinUp Desire - Bordeaux-style blend
Sonoma County		 $30.00 bottle
$360.00 case

To order by fax, please complete the fields below and fax to (707) 433-3437.

Subtotal:

 

DLM Club Members - will receive 20% discount (applied at time of order fulfillment)

 

Add Tax 9.0% CA:

 

Call (707) 433-3711 for SHIPPING CHARGES and PERMITTED STATES:

(Shipping ranges from $28 to $58 per case)

 

Amount Due:

 

Name__________________________________

email_____________________________________

Phone__________________________________

Fax______________________________________

Billing Address (Please Print)

Shipping Address (Please Print)
Address________________________________ Address___________________________________

_______________________________

_________________________________

City____________________________________

City______________________________________

State________________________Zip________

State________________________Zip_________

Billing Phone__________________________

 Shipping Phone__________________________

You must be 21 years old to purchase wines. We can not ship to Post Office box addresses.

Credit Card:  VISA   MasterCard   AMEX (Circle One)

Card #_________________________________

Expiration Date_____________________________

Signature_______________________________

Date_____________________________________

r.10/22/13