MarshAnne Landing Winery
Fax Order Form
(Secure ordering: Print, Complete Form, Sign and Fax or Mail back to MarshAnne Landing)
To: MarshAnne Landing, 381 Hogan Road, Oakland, OR 97462 * Fax Number (541) 459-4499
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Customer Information
Note - you must be 21 years of age or older to purchase wine. Wines will be shipped after receipt of payment. The delivery agent (UPS) requires an adult signature upon delivery. We ship wines anywhere the law allows.
Name: _____________________________________________________________________
Address: ________________________________________ City/State/Zip: _________________
Phone Number: __________________________________ Email Address: _________________
Check or Credit Card (VISA/MasterCard): Check enclosed: ____
Credit Card Type: __________ Number: _______ ________ ________ ________ Expiration: ______/_______
Authorized Signature: _____________________________________________
Date of Birth: _________/__________/____________
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Order Information (Note: Landing Party members, additional discounts apply)
Please circle the Wines/Quantities you are purchasing/ Mixed Cases Yes! (One Case=12 bottles)
Wines Case Price* Bottle Price '01 Merlot $152.00 $14.00 '02 Merlot
$194.00 $18.00 '03 Merlot $216.00 $20.00 '03 Cote du Umpqua $194.00 $18.00 '01 Syrah Grenache $130.00 $12.00 '02 Cabernet Merlot $194.00 $18.00 '02 Red Planet $216.00 $20.00 '03 Syrah $194.00 $18.00 '03 Pinot Noir $174.00 $16.00 '03 Chardonnay $174.00 $16.00 * Includes a 10% discount
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Shipping Information*
We ship UPS Ground to any legal US State.
Landing Party members only--Order $300 or more and we pay for Ground Shipping to any legal state.
Total Purchase Order: Total Wine: ___________ + Shipping (winery will calculate)
*Out of state shipping, where allowed by law, is available to either business or home street address. An adult signature will be required.