Welcome to the Wine Club ordering form

Please fill out the fields and choose from our wines to be delivered for each month.  With your pre-order, you will receive the following discounts.  Shipping quantity and which wines you receive are your choice!  Choose 3, 6 or 12 bottles per shipment.

15% Discount of 12-35 bottles per year

20% Discount of 36+ bottles per year.   For those who choose to purchase 3 or more cases all at once, we will include one of our old vintage Merlots!

The  “Submit” button will forward your completed form to us, you will get a confirmation page if all is well.

Alternately you can also download this form, fill it out and email it back to us or simply just call and we will be happy to set you up! 360.468.3644

We will contact you for billing information.  We charge your card with each shipment; you get our case discount even when you are purchasing three bottles at a time!

PLEASE NOTE: All Fields with a red * need to be completed.  If you do not get an immediate confirmation when you select “Submit” there is likely a field left blank, such as “Country”- scroll up your form to find what is missing.  Thanks!

Name*
E-mail:*
Phone:(1)*
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Billing Address:*
Shipping Address (if different):
Phone:*
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 Order wine using the selection fields below:

January (enter quantity, if any, to total 3, 6 or 12 bottles)

Madeleine Ange ($27, 15%-$22.95, 20%-$21.60) 1
Siegerrebe ($27, 15%-$22.95, 20%-$21.60) 1
Chardonnay ($18, 15%-$15.30, 20%-$14.40) 1
Rosé ($22, 15%-$18.70, 20%-$17.60) 1
Wave Crest White ($27, 15%-$22.95, 20%-$21.60) 1
Malbec ($28, 15%-$23.80, 20%-$22.40) 1
Sangiovese ($26, 15%-$22.10, 20%-$20.80) 1
Raven's Caw Cab Blend ($40, 15%-$34.00, 20%-$32.00) 1
Fireside Port ($28, 15%-$23.80, 20%-$22.40) 1
Raspberry Wine ($28, 15%-$23.80, 20%-$22.40) 1

February (enter quantity, if any, to total 3, 6 or 12 bottles)

Madeleine Ange ($27, 15%-$22.95, 20%-$21.60) 2
Siegerrebe ($27, 15%-$22.95, 20%-$21.60) 2
Chardonnay ($18, 15%-$15.30, 20%-$14.40) 2
Rosé ($20, 15%-$17.00, 20%-$16.00) 2
Wave Crest White ($27, 15%- $22.95, 20%- $21.60) 2
Malbec ($28, 15%-$23.80, 20%-$22.40) 2
Sangiovese ($26, 15%-$22.10, 20%-$20.80) 2
Raven's Caw Cab Blend ($40, 15%-$34.00, 20%-$32.00) 2
Fireside Port ($28, 15%-$24.23, 20%-$22.80) 2
Raspberry Wine ($28, 15%-$23.80, 20%-$22.40) 2

March (enter quantity, if any, to total 3, 6 or 12 bottles)

Madeleine Angie ($27, 15%-$22.95, 20%-$21.60) 3
Siegerrebe ($27, 15%-$22.95, 20%-$21.60) 3
Chardonnay ($18, 15%-$15.30, 20%-$14.40) 3
Rosé ($22, 15%-$18.70, 20%-$17.60) 3
Wave Crest White ($27, 15%-$22.95, 20%-$21.60) 3
Malbec ($28, 15%-$23.80, 20%-$22.40) 3
Sangiovese ($26, 15%-$22.10, 20%-$20.80) 3
Raven's Caw Cab Blend ($40, 15%-$34.00, 20%-$32.00) 3
Fireside Port ($28, 15%-$24.23, 20%-$22.80) 3
Raspberry Wine ($28, 15%-$23.80, 20%-$22.40) 3

April (enter quantity, if any, to total 3, 6 or 12 bottles)

Madeleine Ange ($27, 15%-$22.95, 20%-$21.60) 4
Siegerrebe ($27, 15%-$22.95, 20%-$21.60) 4
Chardonnay ($18, 15%-$15.30, 20%-$14.40) 4
Rosé ($22, 15%-$18.70, 20%-$17.60) 4
Wave Crest White ($27, 15%-$22.95, 20%-$21.60) 4
Malbec ($28, 15%-$23.80, 20%-$22.40) 4
Sangiovese ($26, 15%-$22.10, 20%-$20.80) 4
Raven's Caw Cab Blend ($40, 15%-$34.00, 20%-$32.00) 4
Fireside Port ($28, 15%-$24.23, 20%-$22.80) 4
Raspberry Wine ($28, 15%-$23.80, 20%-$22.40) 4

May (enter quantity, if any, to total 3, 6 or 12 bottles)

Madeleine Ange ($27, 15%-$22.95, 20%-$21.60) 5
Siegerrebe ($27, 15%-$22.95, 20%-$21.60) 5
Chardonnay ($18, 15%-$15.30, 20%-$14.40) 5
Rosé ($22, 15%-$18.70, 20%-$17.60) 5
Wave Crest White ($27, 15%-$22.95, 20%-$21.60) 5
Malbec ($28, 15%-$23.80, 20%-$22.40) 5
Sangiovese ($26, 15%-$22.10, 20%-$20.80) 5
Raven's Caw Cab Blend ($40, 15%-$34.00, 20%-$32.00) 5
Fireside Port ($28, 15%-$24.23, 20%-$22.80) 5
Raspberry Wine ($28, 15%-$23.80, 20%-$22.40) 5

June (enter quantity, if any, to total 3, 6 or 12 bottles)

Madeleine Ange ($27, 15%-$22.95, 20%-$21.60) 6
Siegerrebe ($27, 15%-$22.95, 20%-$21.60) 6
Chardonnay ($18, 15%-$15.30, 20%-$14.40) 6
Rosé ($22, 15%-$18.70, 20%-$17.60) 6
Wave Crest White ($27, 15%-$22.95, 20%-$21.60) 6
Malbec ($28, 15%-$23.80, 20%-$22.40) 6
Sangiovese ($26, 15%-$22.10, 20%-$20.80) 6
Raven's Caw Cab Blend ($40, 15%-$34.00, 20%-$32.00) 6
Fireside Port ($28, 15%-$24.23, 20%-$22.80) 6
Raspberry Wine ($28, 15%-$23.80, 20%-$22.40) 6

July (enter quantity, if any, to total 3, 6 or 12 bottles)

Madeleine Angie ($27, 15%-$22.95, 20%-$21.60) 7
Siegerrebe ($27, 15%-$22.95, 20%-$21.60) 7
Chardonnay ($18, 15%-$15.30, 20%-$14.40) 7
Rosé ($22, 15%-$18.70, 20%-$17.60) 7
Wave Crest White ($27, 15%-$22.95, 20%-$21.60) 7
Malbec ($28, 15%-$23.80, 20%-$22.40) 7
Sangiovese ($26, 15%-$22.10, 20%-$20.80) 7
Raven's Caw Cab Blend ($40, 15%-$34.00, 20%-$32.00) 7
Fireside Port ($28, 15%-$24.23, 20%-$22.80) 7
Raspberry Wine ($28, 15%-$23.80, 20%-$22.40) 7

August (enter quantity, if any, to total 3, 6 or 12 bottles)

Madeleine Ange ($27, 15%-$22.95, 20%-$21.60) 8
Siegerrebe ($27, 15%-$22.95, 20%-$21.60) 8
Chardonnay ($18, 15%-$15.30, 20%-$14.40) 8
Rosé ($22, 15%-$18.70, 20%-$17.60) 8
Wave Crest White ($27, 15%-$22.95, 20%-$21.60) 8
Malbec ($28, 15%-$23.80, 20%-$22.40) 8
Sangiovese ($26, 15%-$22.10, 20%-$20.80) 8
Raven's Caw Cab Blend ($40, 15%-$34.00, 20%-$32.00) 8
Fireside Port ($28, 15%-$24.23, 20%-$22.80) 8
Raspberry Wine ($28, 15%-$23.80, 20%-$22.40) 8

September (enter quantity, if any, to total 3, 6 or 12 bottles)

Madeleine Ange ($27, 15%-$22.95, 20%-$21.60) 9
Siegerrebe ($27, 15%-$22.95, 20%-$21.60) 9
Chardonnay ($18, 15%-$15.30, 20%-$14.40) 9
Rosé ($22, 15%-$18.70, 20%-$17.60) 9
Wave Crest White ($27, 15%-$22.95, 20%-$21.60) 9
Malbec ($28, 15%-$23.80, 20%-$22.40) 9
Sangiovese ($26, 15%-$22.10, 20%-$20.80) 9
Raven's Caw Cab Blend ($40, 15%-$34.00, 20%-$32.00) 9
Fireside Port ($28, 15%-$24.23, 20%-$22.80) 9
Raspberry Wine ($28, 15%-$23.80, 20%-$22.40) 9

October (enter quantity, if any, to total 3, 6 or 12 bottles)

Madeleine Ange ($27, 15%-$22.95, 20%-$21.60) 10
Siegerrebe ($27, 15%-$22.95, 20%-$21.60) 10
Chardonnay ($18, 15%-$15.30, 20%-$14.40) 10
Rosé ($22, 15%-$18.70, 20%-$17.60) 10
Wave Crest White ($27, 15%-$22.95, 20%-$21.60) 10
Malbec ($28, 15%-$23.80, 20%-$22.40) 10
Sangiovese ($26, 15%-$22.10, 20%-$20.80) 10
Raven's Caw Cab Blend ($40, 15%-$34.00, 20%-$32.00) 10
Fireside Port ($28, 15%-$24.23, 20%-$22.80) 10
Raspberry Wine ($28, 15%-$23.80, 20%-$22.40) 10

November (enter quantity, if any, to total 3, 6 or 12 bottles)

Madeleine Ange ($27, 15%-$22.95, 20%-$21.60) 11
Siegerrebe ($27, 15%-$22.95, 20%-$21.60) 11
Chardonnay ($18, 15%-$15.30, 20%-$14.40) 11
Rosé ($22, 15%-$18.70, 20%-$17.60) 11
Wave Crest White ($27, 15%-$22.95, 20%-$21.60) 11
Malbec ($28, 15%-$23.80, 20%-$22.40) 11
Sangiovese ($26, 15%-$22.10, 20%-$20.80) 11
Raven's Caw Cab Blend ($40, 15%-$34.00, 20%-$32.00) 11
Fireside Port ($28, 15%-$24.23, 20%-$22.80) 11
Raspberry Wine ($28, 15%-$23.80, 20%-$22.40)11

December (enter quantity, if any, to total 3, 6 or 12 bottles)

Madeleine Ange ($27, 15%-$22.95, 20%-$21.60) 12
Siegerrebe ($27, 15%-$22.95, 20%-$21.60) 12
Chardonnay ($18, 15%-$15.30, 20%-$14.40) 12
Rosé ($22, 15%-$18.70, 20%-$17.60) 12
Wave Crest White ($27, 15%-$22.95, 20%-$21.60) 12
Malbec ($28, 15%-$23.80, 20%-$22.40) 12
Sangiovese ($26, 15%-$22.10, 20%-$20.80) 12
Raven's Caw Cab Blend ($40, 15%-$34.00, 20%-$32.00)12
Fireside Port ($28, 15%-$24.23, 20%-$22.80) 12
Raspberry Wine ($28, 15%-$23.80, 20%-$22.40) 12