Russell Rosato

Russell Rosato Order

www.passionedivina.com

russellfamilywines@gmail.com

727-424-8040

Please submit your information below. Your credit card will be processed through Square by Joanne Russell.

Flat Rate $25 shipping per box

First and Last Name

Email

Phone Number

*ROSATO ROSE'

Billing Address

Shipping Address (If different from billing)

Use my Credit Card On File with Joanne:

Yes

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CREDIT CARD #:

EXPIRATION DATE:

SECURITY CODE:

Add other Info, like Apt #, a Gift or other delivery instructions:

Russell Rosato