US Wine Order Form for That's Entertainment (2015)

US Credit Card Authorization for That's Entertainment (2015)

Please charge my: *

VISA

MasterCard

Credit Card Number *

Expiry Month *

Expiry Year *

Expiry month

Verification # *

on back of card, beside your signature area

*For your safety and security, we now require that you enter your credit card’s verification number. For Visa or MasterCard, the verification number is a 3-digit number printed on the back of your card. It appears after and to the right of your card number.

Name *

Billing Address *

City

Province/State

Postal code/Zip code *

AUTHORIZATION

Amount of Authorized Charge: $819.00 ($65 per bottle + Tax) USD per case

Authorization *

I hereby authorize The Oak & Priest Wine Company to charge the credit card as indicated above. I declare that the information that I have provided is correct. Under such circumstances, this agreement will remain in effect until terminated by me.

Date *

enter today's date

Email *

Message * We will contact all individuals who have placed orders and confirm order quantity and shipping address. The credit card will be processed only when product is shipped.

If you are human, leave this field blank.

* credit card processing is handled in Canada in C$, converted to US$ by your credit card company. Some slight rounding errors may occur.

COMPLETED FORM will be submitted to

The Oak & Priest Winery
Attention: Lindsay Nyenhuis
Fax: (403) 246-0247
Email: info@oakandpriest.com
Mailing: 1324 17th Ave SW, Suite 200, Calgary, AB, Canada T2T 5S