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