Wine Order Form

Please provide the following information: (note: we will only use your telephone number or email address if it is necessary to contact you regarding this order)

Name:
Daytime Phone:
Your Email Address:
Billing Address:
note: wine cannot be shipped to a PO Box
Shipping Address:
(if different)
Shipping Recipient Phone
(required for FedEx)

Method of Payment: Visa/MasterCard Check/Money Order

Card Number:
Expiration Date:

Check here if you prefer that we call you for your credit card number.


You may print this form for phone, fax or mail orders.
Phone:  607-582-6011
Fax:  607-582-6010

Mail: Lamoreaux Landing Wine Cellars
9224 Route 414
Lodi, NY 14860


Ordering Wine

Please enter quantities of each wine item you wish to order.

Click on the Shipping button (near the bottom of the wine order form) to add shipping charges within NY State and applicable sales tax. For out-of-state shipping please contact the winery and we'll determine the charges (if shipping is allowed to your state). You can then enter the shipping charges and sales tax manually, and the order will be totaled.

Additional charges may apply for shipping of sparkling wine.

Currently Available Wines
Item Price Quantity Total
2005 Chardonnay $12.99
2003 Chardonnay Reserve  (sold out)   $19.99
2005 Dry Riesling   $14.99
2005 Semi-Dry Riesling  (sold out)   $14.99
2005 Gewürztraminer $17.99
Estate White $9.99
2004 Pinot Noir $24.99
Cabernet Franc NV $17.99
2003 Merlot $17.99
Estate Red $9.99
2000 Brut $23.99
2005 Vidal Ice (375 ml)* $22.99
Item Totals
Quantity Discount (-15% on 12 or more bottles)
*discount does not apply to Ice Wines
Subtotal
click Shipping button to add shipping charges within NYS and applicable sales tax
(see table of charges below)
8.00% sales tax
Wine Order Total
Wine Gift Certificate (indicate amount - $10.00 minimum)
Final total, wine order plus gift certificate

New York State Shipping Charges (Shipping available to other states where permissible. Call for out-of-state shipping charges.):

Additional charges apply for some shipments including some sparkling wine. Please inquire.

Prices and availability subject to change without notice.

I understand that when I purchase wine, ownership passes to me upon shipment from the winery. You are authorized on my behalf to arrange shipment of the wine to me. I certify that I am at least 21 (twenty-one) years of age and legally able to purchase wine*.

Signature (mail or fax orders): _____________________________________

* Minors please read warning



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