Culinary Experience Truffles & Foie Gras Truffle and Foie Grass TBD* Plus CA State Tax Gratuity not included in the final price. Please fill in and check all the boxes in red. Failure to do so will cause delays in processing your order. Dinner Host Information first name last name street address address line 2 city state StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming zip code e-mail address phone number (best number to reach you) Dinner Details number of guests Tell us a little about your event (max 200 words) . Billing Information: Amex Visa MC Discover card number* CVV Code* * 3 digit code in back of Visa, Mastercard and Discover. 4 digit code on the front of American Express expiration date* Month01 - January02 - February03 - March04 - April05 - May06 - June07 - July08 - August09 - September10 - October11 - November12 - December Year2015201620172018201920202021202220232024202520262027202820292030 Yes, billing and shipping addresses are the same click here if the shipping and billing addresses are the same street address address line 2 city state StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming zip code PLEASE READ THE RULES CAREFULLY. YOU MUST AGREE WITH THE TERMS AND CONDITIONS IN ORDER TO COMPLETE YOUR PURCHASE. PLEASE CLICK THE BOXES TO CERTIFY YOU UNDERSTAND THE RULES AND CONDITIONS. Dinners may be purchased up to three weeks prior to the date of the dinner. In order to qualify for a full refund, please contact us at (646) 322-3658 or email me at karl@charlemagnefinewines.com three weeks prior to the date of the dinner. No exceptions. We understand that unforseable events beyond a persons control do occur. We will be happy to work with you to reschedule your dinner date if unforseable events such as death, illness and other acts of god occur. Please call (646) 322-3658 or email me at karl@charlemagnefinewines.com as soon as possible to reschedule. Cancellations less than three weeks before the scheduled dinner will incur a penalty of 50% of the final dinner price. Tip is not included in the final price. The gratuity is your responsibility. If you’d like I can add it to the bill or you can take care of it at the end of the night. If you’d like me to add it to your bill, please email me at karl@charlemagnefinewines.com to add it to your bill. Gratuity is 15 to 20% of the final bill. if you have any food allergies or dietary restrictions, please be sure to list it in the Dinner Details section of this form or email me at karl@charlemagnefinewines.com.
