Napa Valley Wine Tasting

at Mealey’s Restaurant

Thursday, April 10, 2008

6:30 pm -10:30 pm

Please Print

Name:

Address:

Email:

City:

State:

Zip Code:

Daytime Phone:

Work Phone:

Cell Phone:

Credit Card or Check Number:

Card Type (if paying with credit card):

Expiration:

Number of People Attending:

Number of persons paying for:

Reservation Party Name:

COMPLETE THIS FORM AND MAIL IT TO: Mealey’s Restaurant,  P.O. Box 300, New Market, MD 21774