AFCOM SARL Customer Wine Order Form Please enable JavaScript in your browser to complete this form. Customer type Phone Customer Name *FirstLastCustomer LocationCentreNorthLittorialNorth WestWestAdamawaEastSouthFar NorthSouth WestPhone Number *Town *Quarter *Wine typeLoma WhiteBaron de CalviniLoma RedChateau de MerlotUnit type brickmaletteQuantity *Submit