MEMORIES ON A BOTTLE

Birthday wine bottle order form

877-580-5984 

You have your choice between alcoholic and non-alcoholic wine. Through Duplin wine, we will only ship alcoholic wine in the state of North Carolina. We will call you to verify an order and to receive payment



E-MAIL ADDRESS(required)

TYPE OF WINE:   When sending a bottle of wine to us, make sure you select a wine that has no label on one side. We will not remove labels. 

QUANTITY:  For case pricing please call

Please select the number of colors and price. The bottle shown has five colors

PRICE:        BOTTLE DESIGN:

All of our bottles are personalized and takes 3-5 weeks for delivery. If you need your order prior to our standard delivery time, please call. All rush orders will be subject to an additional fee of $10.00.


NEXT  THREE  BOXES PERSONALIZE YOUR WINE BOTTLE

TOP NAME : 

BOTTOM  NAME :

NUMERICAL AGE:


BILL TO AND SHIPPING ADDRESS

FIRST NAME:     LAST NAME:

SHIPPING ADDRESS:

CITY:       STATE:    ZIP:

COUNTRY:

Include area code and country code

DAYTIME PHONE :        

HOME PHONE:

FAX:

If you are part of a fund raising effort with prior approval from Memories on a Bottle please list your organization below to assure the 10% donation. If you are not and would like to be, please call (919) 266-0261 for approval

ORGANIZATION:

North Carolina residents are required to pay 6% sales tax. Since all orders are customized, we will call to verify an order. Price does not Include shipping or handling. We accept and .

Your comments or recommendations on images is greatly appreciated.

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