Homewood Winery - Printer Friendly Order Form
Please print out this page and fill in your order. You can either fax your order to 707-996-6935 or mail it to:
Homewood Winery, PO Box 122, Vineburg, CA 95487 - Thank you

Homewood Winery Order Form
Quantity Wine Unit Price Total
       
       
       
       
       
       
       
       
       
       
Customer Information:
Sub-Total
  
Name:
(buyer)
Discount
(*see below)
-
Ship To:
(shipping for business purposes - e.g., business name)
Total w/ Discount
  
Address: ___________________
City: _______________________
State: _______ Zip: ___________
7.5% Tax
(CA Only)
 +
Work Phone: (       ) ____________________
Home Phone: (       ) ____________________
Cell Phone: (       ) ____________________
(please supply at least 2 numbers for ILS Shipping)
Shipper Cost
$5.00 per case/
$2.50 per half case or less (**see below)
 +
Credit Card Information:
Total Due
  
Visa / Master Card / Discover #: ____________________________
Expiration Date (MM/YY): ___________
V-Code: _________
(last 3 digits on back side of card in signature area)
I certify that I am 21 years of age.
Signature: ___________________________________________
(required for ILS Shipping & Authorization for Credit Card)