Big Creek Vineyard Order Form - pocono, poconos, wine, vineyard, gifts,winery, grapes, wine

Big Creek Vineyard Order.
You Must be Over 21 Years of Age to Order.

(Please Fill Out Form and Transmit, or Print and FAX or Mail.) FAX to 610-681-3960
Phone : 610-681-3959. Mail to Big Creek Vineyard
R.R. 1 Box 1011, Kunkletown, PA. 18058

---- Wine ----	Qty @ Bottles	Qty @ 12 Bottle Cases, 10% Off for Case Lots.)
Vin di Pasqualina	@ 7.00/bottle	@ 75.60/case
Chambourcin	@ 8.00/bottle	@ 86.40/case
Chambourcin Riserva	@ 9.00/bottle	@ 97.20/case
Dulcinea	@ 7.00/bottle	@ 75.60/case
Seyval	@ 6.00/bottle	@ 64.80/case

Credit Card:
Card No:
Card Expire Date:	Phone:
Name:
Address:
City, State, Zip:
Email Address : (for online order)
Shipping Address & Instructions

Big Creek Vineyard Order. You Must be Over 21 Years of Age to Order.
(Please Fill Out Form and Transmit, or Print and FAX or Mail.)	FAX to 610-681-3960 Phone : 610-681-3959.	Mail to Big Creek Vineyard R.R. 1 Box 1011, Kunkletown, PA. 18058