Wine Label Customization Form
Please complete this form to finalize your wine order in support of MHS. We will contact you when the wine is available for pick up.
To order wine, visit www.pashandglou.com/products/mhs
For questions, please contact the MHS Humane Leader coordinating this event at brittanymlaw@gmail.com.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Wine Selection
Enter each unique combination (wine type + label) in a new row. We will cross reference your submission below with the amount ordered from Pash & Glou. If you ordered multiple cases (12 bottles) and want the same label on each, please simply note this in the final question.
Please complete for each unique combination ordered. NOTE: If you ordered multiple sets (3 bottles per set) and want a mix of red and white, you will need to split the order and enter in separate rows. If you ordered more than 4 cases, simply note the splits in the box at the end of the survey or complete this survey again (required if using more than 4 images).
*
Quantity
Wine Type
Pet Name for Label
File Name of Label Image (required if ordering more than one label image)
Combo 1
3
6
9
12
Red / Blend
White / Pinot Grigio
Combo 2
3
6
9
12
Red / Blend
White / Pinot Grigio
Combo 3
3
6
9
12
Red / Blend
White / Pinot Grigio
Combo 4
3
6
9
12
Red / Blend
White / Pinot Grigio
Please upload pet image(s) for the label.
Browse Files
Drag and drop files here
Choose a file
If multiple images are being submitted, make sure the file name matches the name indicated above.
Cancel
of
Please share any additional details you think we might need. Please indicate here if you do NOT want the background removed from your pet photo.
Submit
Should be Empty: