The Vineyard Home
 

 

Please print out this order form and mail or fax to us.

Send order to: The Vineyard Home          fax: (304)
                        101 Cantwell Court              289-3900
                        Purgitsville, WV 26852

The Vineyard

101 CANTWELL COURT PURGITSVILLE, W VA 26852. 304-289-3493

1-877-RGRAPES (Orders Only)

Mon-Fri 8-5 EST Sat-Sun 1-4

FAX Orders to above number after 9 p.m. EST

email vineyardhome@frontiernet.net

ORDERING INSTRUCTIONS

1. Please print or type order.

2. Be sure all addresses are complete and legible. Include apartment numbers.

3. Specify arrival date.

4. Please make sure addresses are correct to ensure proper delivery.

Due to Weather

No candy shipments between April 15th and October 15th

Allow additional delivery time for orders outside the continental United States

Allow two weeks for delivery.

TO ENSURE CHRISTMAS DELIVERY

ORDERS MUST BE RECEIVED BY DEC. 5th, 2008

NAME:

ARRIVAL TIME

Q Now D Thanksgiving D Christmas D Easter D Valentines

GIFT NO.

QUANTITY

AMOUNT

 

 

 

 

 

 

%

STREET:

 

 

 

 

$

CITY:

STATE: ZIP:

 

 

 

 

$

GREETING TO READ

 

 

 

 

 

 

 

 

 

 

 

 

NAME:

ARRIVAL TIME

D Now LU Thanksgiving LJ Christmas t—\ Raster LJ Valentines

GIFT NO.

QUANTITY

AMOUNT

 

 

 

 

 

 

%

STREET:

 

 

 

 

$

CITY:

STATE: ZIP:

GREETING TO READ

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

NAME:

ARRIVAL TIME

n now

LJ Thanksgiving LJ Christmas LJ Easter LJ Valentines

GIFT NO.

QUANTITY

AMOUNT

 

 

 

 

 

 

$

STREET:

 

 

 

 

$

CITY:

STATE: ZIP:

GREETING TO READ

 

 

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

NAME:

ARRIVAL

TIME

D Now LJ Thanksgiving LJ Christmas LH Easter L~] Valentines

GIFT NO.

QUANTITY

AMOUNT

 

 

 

 

 

 

f -

STREET:

 

 

 

 

$

CITY:

STATE: ZIP:

GREETING TO READ

 

 

 

 

$

 

 

Shipping & handling

 

 

 

 

 

 

DONOR'S NAME:

 

 

TOTAL

STREET:

CITY: STATE: ZIP:

PHONE: