ORDER FORM
How to Order Wine for U.P.S. Shipments in Ohio
___Btls of 750ml Midsummer Moon @ $10.00 ea          $________

___Btls of 750ml Summer Solstice @$10.00 ea            $________

___Btls of 375ml Summer Solstice@ $6.00 ea              $________

___Btls of 750ml Concord @ $8.00 ea                          $________

___Btls of 750ml Niagara @ $8.00 ea                           $________
 
___Btls of 750ml Red Table Wine@ $8.00ea          $________

___Btls of 750ml White Table Wine @ $8.00 ea            $________

___Btls of 750ml Pink Catawba @ $8.00 ea           $________




Wine Subtotal$________

6.5% Sales Tax     $________

Add Shipping Charges   $________
                                                                     



Total Amount Due                                                       $________



Shipping Charges

3 Bottles...................$6.50
6 Bottles...................$9.00
12 Bottles.................$12.50


Shipping Instructions

Ship To:  ______________________________________________


C/O:___________________________________________________


Address:_______________________________________________


City:_______________________________________Ohio


Zip:____________________________________




Sold To:_______________________________________________


Address:______________________________________________


City: __________________________________________________


State:______________________Zip:__________________


Phone: (        )  _________________________

Please include phone number so we may contact you to clarify or check on shipping instructions




FORMS OF PAYMENT

Check Enclosed                                  Money Order


Please make checks payable to Jilbery Winery 1496 Columbia Road Valley City, Ohio 44280

Charge to My Account:

Visa                                         Mastercard


ACCOUNT NUMBER______________________________________


Expiration Date:________________________


Signature________________________________________

This page was last updated on: February 7, 2008

Order by Mail Print out the order form.  Send us your order with your payment to Jilbert Winery 1496 Columbia Road Valley City, Ohio 44280

Order by Phone  Credit card orders may be placed by calling 216-781-4120 ask for David Jilbert

Order by Fax  Print out and complete the order form and fax to (216) 241-5720



Be sure you have provided an accurate shipping address and that an adult at least 21 years of age will be available to sign for package during regular business hours. Please note that wines must be shipped to an Ohio address only.

Your order will be processed immediately and delivered to your home within days. We guarantee delivery in good condition to the shipping address. We guarantee your satisfaction
Ordering Instructions