| Billing Address |
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| Gremark Vineyards Order Form |
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| Shipping Address (Business Address Preferred) |
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| Please print and complete this form and fax or send it to the following address. Gremark VIneyards, 5325 Rancho La Loma Linda Dr., Paso Robles, CA 93446. Or call us at Tel: 805-237-0154 Fax: 805-237-0154 |