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Gift Card Order Form
Your E-Mail
NOTICE: You must be 21 years of age to purchase alcoholic beverages. Ordering confirms you are at least 21.
Important: Enter a valid e-mail address. Receipts will be sent to this address.
*E-Mail:
You may purchase a Gift Card in any Dollar Amount
Number of Gift Cards
Dollar Amount per card (if multiple separate by comma)
Recipient(s) - List in Comments with Address(s) and Gift Note
FREE SHIPPING by USPS
Your Billing Information
*Your Date of Birth
You must be 21 or older
*First Name:
Same name as on your card
Middle Initial:
*Last Name:
*Address Line 1:
Address Line 2:
Apt. or Suite No.
*City:
*State:
Choose a State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
*Zip Code:
*Phone:
Company Name:
If applicable
Credit/Debit Card Information
*Card Number:
No dashes or spaces please
*Expiration Month:
Month
January
February
March
April
May
June
July
August
September
October
November
December
From your card
*Expiration Year:
Year
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
From your card
*Card Brand:
Choose a Card
American Express
Discover
Master Card
Visa
*CVV2:
Card Security Code
Comments
NOTICE: You must be 21 years of age to purchase alcoholic beverages. Ordering confirms you are at least 21.
For first time online orders: please scan and email a pic of your drivers license (front and back) to Frank@FranksWine.com for age verification.``
****THIS OFFER IS VOID WHEN AND WHERE PROHIBITED****
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