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Special Order
Name
First Name
Last Name
Phone Number
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Preferred Contact:
Phone
Text
Product Requested
*
Product Size
*
Product Category:
*
Please Select
Wine
Spirits
Beer (only available by case)
Non-Alcoholic
Cigars
Requested Quantity
*
Case or Bottle(s)
*
Please Select
Case
Bottle(s)
Stock Options
*
Please Select
One Time Order
Stock on shelf
Would customer like an additional product?
Yes
Product Requested #2
*
Product Size #2
*
Product Category #2:
*
Please Select
Wine
Spirits
Beer (only available by case)
Non-Alcoholic
Cigars
Requested Quantity #2
*
Case or Bottle(s) #2
*
Please Select
Case
Bottle(s)
Stock Options #2
*
Please Select
One Time Order
Stock on shelf
Pricing Options
*
Please Select
Order without price notification
Send pricing before ordering
Additional information:
In Store Use Only: Employee Initials
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Fareway Wine and Spirits
Are you over 21 years of age?
Yes
No
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