Lorca Wines - Order Form

Please mail or fax your orders to:

Lorca Wines
P.O. Box 207
Rutherford, CA 94574
Fx 707-968-9397

After the receipt of your reservation form, we will invoice you for payment and your cancelled check will be your receipt. Shipping will be added to your invoice, quantity of wine ordered and method of shipping will affect the costs.

For Pick Up: I will pick up on: ______________ I will call with pick up date: _________

For Shipping: Please ship by ground________ air________

Ship to: (Must be one of the following states-CA, CO, ID, IA, IL, MN, MO, NM, NV, OR, WA, WI, WV)

Phone:

Number Ordered	Size	Wine Description	Price	Total
		1999 Petite Sirah Napa Valley	$40.00
		2000 Pinot Blanc Monterey County	$15.00
		2000 Pinot Gris Monterey County	$15.00
		1999 Pinot Noir Garys Vineyard	$40.00
		1999 Pinot Noir Pisoni Vineyard	$50.00
		1997-1999 Petite Sirah Napa Valley Vertical	$120.00

		Gift Items
		Lorca T-Shirt (M-XL) Natural with embroidered logo on left chest	$20.00
			$20.00
		Handcrafted Wine Charms (Set of 6)	$24.00
			Subtotal
			CA add 7.50% sales tax
			Total

Alcoholic beverages may be sold and delivered only to persons who are at least 21 years old. In placing your order, you represent to us that you are at least 21 years old and that the person to whom you are directing delivery is at least 21 years old. When your alcoholic beverages are delivered, the person receiving delivery will be required to show