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.

* 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