Order Wine

Mokelumne Glen Vineyards FAX (209) - 333-7628

8441 E. Schmiedt Rd. email: mokglen@lodinet.com

Lodi , Ca. 95240

Note: 10% discount on 12 bottle cases. Mixed cases acceptable.

Please send:

_____ bottles 1999 Zinfandel Rosé @ $7.50 = ______ ______

_____ bottles 2001 Chardonnay @ $10.50 = ______ ______

_____ bottles 2002 Kerner @ $12.75 = ______ ______

_____ bottles 2001 Viognier @ $12.00 = ______ ______

_____ bottles 2001 Zinfandel @ $12.00 = ______ ______

sub-total ______

- 10% discount if applicable ______

sub-total ______

7.75% sales tax ______

Shipping/Handling (only available in California at this time)

_____ 3 pack @ $16 = ______ wine total ______

_____ 6 pack @ $20 = ______

_____ 12 pack (1 case) @ $33 = ______

S/H total ______ S/H total ______

Order total ______

Please include check with order. We accept checks only at this time.

SHIP TO: We hope to accept credit cards in the future.

Name ____________________________________________

Company _________________________________________ Phone ( ) ___________________

Street Address _____________________________________ e-mail ___________________________

City, State, Zip _____________________________________ Signature ________________________

Must be 21 years of age. Signature and ID may be required at delivery. Please allow up to 3 weeks for delivery. Thank you for your order.