CONTACT INFO		BILL TO:
Name		Name
eMail		Address
		Address
Phone		City, ST. Zip
Fax		Phone

Payment type	Credit Card Number	Exp.
MC / VISA / DISCOVER

Ship Method	Ship Date
Overnight / 2nd Day / 3 Day / Ground / Saturday

Qty.	Code	Item Description	Unit Price	Total

Directions:

• Fill out Form.
• Fax Form to 314-773-1090
• Send recipient list to Internetwines
  • Fax list to same number 314-773-1090
  • eMail list in .txt, .cvs, or excel 97 format to info@internetwines.com. Use Fax Corp Order List as the Subject
• Please include Gift Message either in fax or eMail
• You may also send company logo in jpg or gif format for use on the gift cards.
  • Max size is 200 x 200 pixels. Send as an attachment.