Corporate Gifts Purchasing Form Purchaser's Information Company Name Contact Name Email Phone Billing Address City State Select AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Zip Code Use Card On File Contact for New Credit Card Recipient's Information Name Company Email Phone Shipping Address City State Select AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Zip Code Ship Via: UPS GROUND (included) UPS 2nd DAY* UPS Next Day* Address Type: Business Address Residential Address * standard UPS rates applied for 2nd Day and Next Day will be additional Message Gift Type Spirits (CALIFORNIA ONLY) Wine Spirits Gift Level VIP - One Bottle up to $500* A - One Bottle $150 - $200* B - One Bottle $100 - $150* C - One Bottle $75 - $100* * Includes bottle price/tax/shipping. Spirits Type Bourbon Mezcal Gin Whiskey Tequila Scotch Vodka Other Wine Gift Level VIP - Two Bottles up to $500* A - Two Bottles $150 - $200* B - Two Bottles $100 - $150* C - Two Bottles $75 - $100* * Includes bottles price/tax/shipping. UPS GROUND (included), UPS 2nd DAY or UPS Next Day (standard UPS rates applied for 2nd Day and Next Day will be additional) Wine Type (Bottle 1) Cabernet Sauvignon Pinot Noir Red Blend Zinfandel Champagne / Sparkling Chardonnay Sauvignon Blanc White Blend Other Wine Type (Bottle 2) Cabernet Sauvignon Pinot Noir Red Blend Zinfandel Champagne / Sparkling Chardonnay Sauvignon Blanc White Blend Other Confirm Contact Info Contact Name Email Phone
