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Potomac Highland Winery Order Form

Name:
Address:
State:
Country:
E-Mail:
Phone:
Chardonnay (number of bottles): $12 per bottle
Riesling (number of bottles): $12 per bottle
Seyval Blanc (number of bottles): $9 per bottle
Chancellor (number of bottles): $12 per bottle
Chambourcin (number of bottles): $12 per bottle
Meritage (number of bottles): $14 per bottle
Pinot Noir (number of bottles): $14 per bottle
Seyval Blush (number of bottles): $12 per bottle
Comments:
Please check this box to
have a brochure mailed to you: