ORDER FORM

In order to supply you the approriate plant please indicate your soil type.

Soil Identification:

Clay Sand Loam

RED
Red - Cabernet Franc	Quantity
Red - Cabernet Sauvignon	Quantity
Red - Grenache	Quantity
Red - Merlot	Quantity
Red - Pinot Noir	Quantity
Red - Syrah	Quantity
Red - Zinfindal	Quantity
WHITE
White - Chardonnay	Quantity
White - Pinot Grigio	Quantity
White - Sauvignon Blanc	Quantity
TABLE GRAPES
Seeded Red	Quantity
Seedless Black	Quantity
Seedless Red	Quantity
Seedless White	Quantity

Billing Address

First Name:	Required
Last Name:	Required
Address:	Required
City:	Required
State:	Required
Zip Code:	Required
Phone:
Fax:
Email:	Required
Credit Card Type	Visa MasterCard Discover Required
Card Holder's Name	Required
Card Number	Required
Expiration Date	Required
CCV number	What's this?

Shipping Address

First Name:	Required
Last Name:	Required
Address:	Required
City:	Required
State:	Required
Zip Code:	Required