Nelson Estate - Sonoma County Russian River and Sonoma Valley Wines

Billing Information
First Name*:
Last Name*:
E-mail*:
Street:
City:
State:
Zip:
Phone:
Fax:

Payment Info

Please feel free to either submit this form online, by fax or by mail. Our fax number is 206-241-9463. Our mailing address: PO Box 66067 Seattle, WA 98166

Dave or Holly Nelson will contact you to obtain payment information prior to shipping your wine.

We take checks, MasterCard, Visa, and American Express.

Comments and Special Requests
(If you would like to change the shipment with a specific vintage or varietal, just ask and we'll do our best to accomodate you!)

Please include me in your mailing list

This is a gift membership:

Shipping Address if Different
Because a signature is required for delivery, we recommend shipping to a work address.
Name:
Street:
City:
State:
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Shipment Options
Option 'A'	Option 'B'	Alternate
$87.55** Chardonnay Pinot Noir Merlot Cabernet Franc	$101.15** Pinot Noir Merlot Cabernet Franc Vintage Port	Alternating 'A' and 'B' Shipments
**Plus taxes and shipping

Statement of Policy

I certify that I am 21 years of age or older.
I authorize Nelson Estate to charge my credit card for each shipment.
I may cancel my membership at any time.
I understand that I am to notify Nelson Estate of changes to my billing/shipping address.
Extra shipping charges resulting from incorrect address information are my responsibility.
Shipments cannot be made to PO boxes.

I have read and accept the above policy.*

*Required to join.