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Dynamic Forms

To be Completed by Employee

Print Legibly

Employee Name:

*

Employee ID:

*

Location:

*

Telephone:

*

Order date:

Select Date

Total of Cases:

Total Amount $:

Check:
YesNo

Brand

Type

Price

Cases

Total Cost

Franzia

Chardonnay:

Cabernet Sauvignon:

Merlot:

White Zinfandel:

White Merlot:

White Grenache:

Chablis:

Rhine:

Burgundy:

Chianti:

Refreshing White:

Crisp White:

Sunset Blush:

Chillable Red:

Fruity Red Sangria:

Corbett Canyon

3L Wine Casks

Chardonnay:

White Zinfandel:

Cabernet Suavignon:

Pinot Grigio:

Merlot:

Corbett Canyon

1.5L

Chardonnay:

Cabernet Suavignon:

Merlot:

White Zinfandel:

Pinot Grigio Chennin Blanc:

Lgen Ellen

RESERVE

1.5L

Chardonnay:

Cabernet Suavignon:

Merlot:

White Zinfande:

Pinot Grigio:

Glen Ellen

RESERVE

750ML

Chardonnay:

Cabernet Suavignon:

Merlot:

White Zinfande:

Pinot Grigio:

Glen Ellen

RESERVE

250ML

GlenEllen250Price1:

Cabernet Suavignon:

Merlot:

White Zinfande:

Pinot Grigio:

FISHEYE

WINERY

750ML

Chardonnay:

Cabernet Suavignon:

Merlot:

Pinot Grigio:

Shiraz:

Riesling:

FISHEYE

WINERY

3.0L

Chardonnay:

Pinot Grigio:

Shiraz:

FISHEYE

WINERY

250ML

Chardonnay:

Merlot:

FOXHORN

VINEYARDS

750ML

Chardonnay:

Cabernet Suavignon:

Merlot:

White Zinfande:

Concannon

Selected Vineyards

750ML

Chardonnay:

Syrah:

Cabernet Suavignon:

Suavignon Blanc:

Merlot:

Pinot Gris:

Petite Sirah LMT REL:

Big House

Red 750ml:

White 750ml:

Pink 750ml:

Angel Juice 3L

Chardonnay:

Killer Juice 3L

Cabernet Suavignon:

Pinot Evil

Pinot Noir 3L:

Pinot Noir 750ml:

Hearding cats

Merlot / Pinotage:

Chenin Blanc / Chardonnay:

Cabernet Suav / Shiraz:

Chardonnay / Viognier:

Cupcake

Chardonnay:

Suavignon Blanc:

Cabernet Suavignon:

Total Cases and Amount:

Total Cases

Total Cost

Submit

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