2004 Marburg Estate Mail Order Form 2004		https://www.marburgwine.com
	Print, fill out and mail this form with enclosed check or money order made out to:
	Marburg Estate Winery Ltd.
	2025 Locust Road
	Spring Grove, PA 17362
	Customer Name
	Customer Address
	Customer Phone Number
	Customer Email Address
	Would you like to be on our mailing list ?				Yes r or No r
		Size	Price	Qty.	Total Price
	Autumn Frost	750 ml	$11.00
	Autumn Frost	375 ml	$7.00
	Opus II	750 ml	$9.00
	Opus II	375 ml	$6.00
	Chardonnay	750 ml	$13.00
	Chardonnay	375 ml	$8.00
	Hidden Creek	750 ml	$10.00
	Hidden Creek	375 ml	$7.00
	Cabernet Sauvignon	750 ml	$14.00
	Cabernet Sauvignon	375 ml	$9.00
	Smokehouse Red	750 ml	$11.00
	Smokehouse Red	375 ml	$7.00
	Ruby Red	750 ml	$10.00
	Ruby Red	375 ml	$7.00
	Gift Certificates are available in any denomination
	Total bottles
	Sub total				$
	Plus Shipping Estimate (25%)				$
	�Mix or match � 12 bottles per case	Less Case discount(10%)			$
	Total				$
	Credit Cards "for approved accounts only"
	Card Type
	Card Number				Exp Date
	Card Holders Signature