ORDER FORM: Phone, Fax or Mail 
1. Type in your order and information.
2. Print form.
3. Sign, and mail or fax to Mackenzie Vineyards along with payment. We also accept phone orders.

PHONE: 707-887-8130 or Fax: 707-887-8160

MAIL: Mackenzie Vineyards, 5220 Ross Road, Sebastopol, CA 95472

*You must be 21 or older to purchase wine. Wine must be delivered to an address where an individual of at least 21 years of age is available to sign for wines during regular business hours.
Wine can easily be delivered to a business address.

Non-California residents, we are prohibited to ship directly to the following states; Alabama, Arkansas, Connecticut, Delaware, Georgia, Kansas, Kentucky, Maine, Maryland, Massachusetts, Mississippi, Montana, New Jersey, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Tennessee, Texas, Utah.
Please e-mail us at:wine@mackenzievineyards.com for state retail distributors information.

Orders of 1 case (12 bottles) or more receive 10% discount on wine total.


VARIETY

VINTAGE / APPELLATION

PRICE

# BOTTLE

TOTAL

Chardonnay

 2008
 Sonoma County

$13.00

x

= $

Cabernet
Sauvignon

2007
Sonoma County

$14.00

x

= $

Merlot

 2007
 Sonoma County

$14.00

x

= $

Pinot Noir

 2008 SOLD OUT
 Russian River Valley

$18.00

x

= $

Wine Total 

= $

Case Discount 
(see below) 

- $

Sub-Total

= $

Sales Tax
(California deliveries add 9% ) 

+ $

Add Delivery Costs  (see below) 

+ $

TOTAL AMOUNT DUE

= $


Case Discount: Take 10% off wine total when ordering by the case.12 bottles per case, cases can be mixed.

Delivery Costs:

3 Bottles = $14

6 Bottles = $18

12 Bottles = $26



Ship To: 

This address is:

Name:

Street Address:

City & State:

Zip Code:
 

Phone:

 

FAX:

E-mail:


Method of Payment: 

Payment Method:

If paying by credit card, enter Credit Card #, Security Code,
Exp. Date, Name on Credit Card and Billing Address.
We accept Checks, Money Orders, Visa or Mastercard (sorry no American Express or Discover)

Credit Card #:

 -  -  - 

Credit Card Security Code:

Code is the last three numbers on back of card.

Exp. Date:  

Name on Card:

Street Address:

City & State:

Zip Code:

Phone:



Signature   __________________________________
(Please sign here before mailing or faxing)     Thank You for Your Order....ENJOY!