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Wine of the Month Club
Form

Click on above link for Word Format
Each month we will select two wines
from Iowa wineries to ship to you. This is a great way to try all the
different Iowa Wines. You make the choice of the wines you like, by
choosing from Reds, Whites, or Blush, or a combination.
We have 2, 3, 6, or 12 month
subscriptions available. Which makes gift buying simple!
All wine deliveries must be signed
for by a person over the age of 21, please make sure someone will be available
to sign when it arrives. We recommend that wines be delivered to a work
address.
Due to the differing state laws,
currently we will only be able to ship in Iowa.
Ship to: (all recipients must be over
21)
Name:
________________________________________________________________________________________
Address:
______________________________________________________________________________________
2 Whites _____ 2 Red
_____ 2 Blush _____ Combination _____
_____ Dry _____ Semi
Sweet _____ Sweet
2 month $98 _____ 3 Month
$145 _____ 6 Month $280 _____ 12 Month $530 _____
Bill to: Same _____
Phone: __________________________________
Name:
_________________________________________________________________________________________
Address:
______________________________________________________________________________________
MC/Visa/Discover:
_______________________________________________________
Expiration: ____________________
CCV: _______________________
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