Carol Shelton Wines

An adult at least 21 years of age MUST be present to sign for the wine on delivery
We CANNOT ship to P.O. Boxes; business address is preferred
* REQUIRED FIELDS

MAILING INFORMATION
Name:	*
Address:	*
City:	*
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Phone:	*
Fax:
E-mail:	*

SHIPPING INFORMATION
Same as mailing address
Company:
Attention
Address:
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Phone:

2004 Monga Zin, Cucamonga Valley	$252/case
2004 Monga Zin, Cucamonga Valley	$63/3-pack

2005 Wild Thing Zin, Mendocino Co.	$336/case
2005 Wild Thing Zin, Mendocino Co.	$84/3-pack

2005 Karma Zin, Russian River Valley	$396/case
2005 Karma Zin, Russian River Valley	$99/3-pack

2005 Rocky Reserve Zin, Dry Creek Valley	$396/case
2005 Rocky Reserve Zin, Dry Creek Valley	$99/3-pack

Mixed case, 3 bottles of each of above Mixed 4-pack, 1 bottle each of above	$345/case
	$115/4-pack

Visa or Master Card Number :

Sorry, but we do not accept American Express or Discover -

Expiration Date: /

Wine Total

10% Full Case Discount

Subtotal

Note: This form is not secure. If this is a concern for you, please fax or mail us a printed version of this form with your credit card number or check.

Make Check Payable to: Carol Shelton Wines
(P.O. Box 755, Windsor, CA 95492)

Sales Tax

Shipping Charge

Total

I certify that I am at least 21 yrs of age and have read the Disclaimer .