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FAX
OR MAIL ORDER FORM
ABN 91 324 936 016 |
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First
Name:
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Surname:
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Delivery
Address: |
Please include City, State & P/C |
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Phone:
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Fax:
Please include Area code |
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Email:
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PRICE LIST |
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($) Bottle/($) Carton |
Nº of Bottles |
Total $ |
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| 2000 PINOT NOIR BLUSH |
$18.00/$216.00 |
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| 2001 PINOT SPARKLING |
$25.00/$300.00 |
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| 2002 PINOT |
$28.00/$336.00 |
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| 2003 PINOT |
$25.00/$300.00 |
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| Single/Case Lot Freight cost | ||||
Total Single or Case Lots:
@ |
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| Insurance included in above prices, Goods insured against physical loss and damage must be packaged appropriately for road transport |
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Total: $ |
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Credit
Card:
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Card
Number:
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Expiry
Date:
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Name
on Card:
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NOTE: Only persons 18 years and over may purchase our wines. For POA product please contact Loch-Lea Vineyard before ordering Ph: +61 3 6330 1444 Fax: +61 3 6330 2190 email: info@loch-lea.com.au PO Box 1144, Legana, 7277, Tasmania, Australia |
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