THE FORTH DIMENSION
To enter, just print and fill out the form below and send by mail
2335 West Dry Creek Road, Healdsburg, CA 95448
or fax 707.473.0524
THE FORTH DIMENSION
To enter, just print and fill out the form below and send by mail
2335 West Dry Creek Road, Healdsburg, CA 95448
or fax 707.473.0524
Name of 4th Dimension member/s_____________________________________________
Is it a gift membership?
If so, a gift card will be sent on your behalf to the recipient in time for the holidays.
Nope, it's for me! _____ Yes ___ (If yes, then) To: ____________________ From:_______________
Personal greeting to recipient___________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
Name of card holder, if other than member___________________________________________
Billing address_____________________________________________________________________
___________________________________________________________________________________
Telephone #_______________________________________________________________________
Hold at winery for pick up ___ Ship to address below ____
Shipping address___________________________________________________________________
___________________________________________________________________________________
(for least expensive delivery use a business address, if possible)
Telephone # at shipping address____________________________
Credit Card#_________________________exp______________
Signature of cardholder___________________________________
WELCOME TO
THE FORTH DIMENSION!