W(h)ine With Me Wednesday Questionnaire
Sponsored by Hot Country 103
Your Name (for Live Shoutout!)
First Name
Last Name
Email
example@example.com
What Is The Name of The Winery?
*
If Winery Name is not known, indicate "N/A"
What Is The Location of The Winery?
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Tell Us About The Winery:
What Is The Name of The Wine?
*
What Type of Wine Is It? (Merlot, Cabernet, Zinfandel, etc.)
*
What Is The Price Per Bottle? ($USD)
Describe The Wine
*
What Does This Wine Pair Well With?
How Can This Wine Be Purchased? (Online, in stores, direct at winery)
Any Additional Information You Would Like To Share:
Submit
Should be Empty: