THE FORT WINE CO. FAX WINE ORDER FORM ~ 604-857-1139
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TABLE WINES
VOLUME
PRICE PER BOTTLE**
QUANTITY
TOTAL
Cranberry Wine 750 ml $12.60    
Blueberry Wine 750 ml $14.00    
Blueberry Wine 375 ml $14.00    
Strawberry Wine 750 ml $14.00    
Peach Apricot Wine 750 ml $14.00    
White Cranberry Wine 750 ml $14.00    
Green Apple Wine 750 ml $12.60    
Cranberry Wine 375 ml $7.40    
White Cranberry Wine 375 ml $8.00    
Blueberry Wine 375 ml $8.00    
Blueberry Wine 375 ml $8.00    
Peach Apricot Wine 375 ml $8.00    
Strawberry Wine 375 ml $8.00    
Iced Apple Wine 375 ml $23.00    
FORTIFIED DESSERT WINES
VOLUME
PRICE PER BOTTLE**
QUANTITY
TOTAL
Gold Rush 375 ml $20.10    
Cranberry Klondike 375 ml $20.10    
Raspberry Portage 375 ml $20.10    
Wild Blue Yonder 375 ml $20.10    
Wild West Blackberry 375 ml $20.10    
Wild West Blackberry 200 ml $15.10    
TOTALS:
    
**Price includes applicable taxes and bottle deposit. Shipping cost extra.

Billing Information (Please Print Clearly):                  
*Name:
 *Date:
*Street Address:  
*City: *Province: *Postal Code:
*Phone: Fax: E-mail:
*Visa Or M/C (please circle) #
 *Expiry ___/___

Shipping Address (If different than above):
*Name:  
*Street Address:  
*City: *Province: *Postal Code:
*Phone: Fax: E-mail:
*Mandatory fields.       We will contact you to confirm your order and shipping costs at the billing info telephone number that you supplied above.  All information is confidential.