ORDER FORM! ORDER FORM!

2007 HARVEST

Mail, FAX, or Bring in now!

(NO E-MAIL ORDERS) (NO PHONE ORDERS!)

To: The Home Wine/Beer/Cheesemaking Shop

22836-2 Ventura Blvd. Woodland Hills, Ca. 91364

(FAX: 818-224-3812) (Phone: 800-559-9922)

(Sorry, no e-mail or phone ordering.)

PRINT CLEARLY

     VARIETAL                 QUANTITY            $/Lb or Gal.         $ AMOUNT

_____________________     _____________           __________          ____________

_____________________     _____________           __________          ____________

_____________________     _____________           __________          ____________

_____________________     _____________           __________          ____________

_____________________     _____________           __________          ____________

NAME ______________________________________

ADDRESS ____________________________    GRAND TOTALS   $____________

_____________________________ ZIP___________      

                                                   (-) QUANTITY DISCOUNT   $____________

E-MAIL ADDRESS: _________________________________________   

DAY PHONE (        )-___________________           SUBTOTAL     $____________

CELL PHONE (        )-___________________

EVENING PHONE (        )-___________________

I'll be out-of-town from _________________    (-) 50% DEPOSIT $____________

My back-up is __________________________ Phone ________________                 

                       AMOUNT OF CHECK or CHARGE ENCLOSED $____________

Visa/MC/Disc/AMEX # _________________________________________________

Signature _______________________________ Expiration date _______________