Wine Bottle Order Form

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Proceeds go to Holy Family School's Washington D.C. Trip

Name *

Address *

Phone Number *

Email Address

New Dishes

Color of the bottle *

Clear ($10)

Green ($10)

Amber ($10)

Blue ($10)

Special Occasion Bottle ($15)

Handmade Ceramic Items

Small Leaf Dish ($10)

Large Leaf Dish ($15)

Bird House ($25)

Clear selection

Wine Bottle Samples

Bottle Shape *

Flat

Fluted (Wavy)

Curved Neck Bottle

Spoon Rest

Swirled Pattern

Dragonfly Pattern

Christmas Tree

I am ordering a dish!

Special Requests or if ordering more than one bottle please specify in the box below

Pick up details: *

Holy Family School (8am-2:15)

Diane's House

Drop Off ($3 fee)

Other:

Decorated *

Yes decorate it!

No keep it plain!

Other:

Required

Total Amount *

Method of Payment *

Cash/Check

Credit

Other:

Payment:

PLEASE NOTE: Your order is not final until you hit the submit button!

Cash, Check or Credit accepted. Check payable to Holy Family School (in memo state Washington or Wine Bottle)

Credit card: Follow the instructions on the pop up screen after you hit the "Submit" button.

Questions or concerns please contact Diane Schoster (513) 324-6921 or dschoster@theholyfamilyschool.org

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