Carindale Wines Order Form

To ORDER you may either     

                 a)  PRINT the form & fax it to us at Carindale Wines  on:  02 4998 7065

     OR      b) 'click' the SUBMIT button.  Your order  will be confirmed by Email.

Freight:   Local $5.00 /case  NSW $12.00 /case Vic/Qld $15.00 /case Other states  $25.00 /case                                     (Minimum 1 dozen bottles per order)
                Overseas Freight rates will be advised by E-mail with a request for confirmation of the order.

Enter the number of bottles for each wine and select your destination.
 

   
No.
Bottles
Cost
Carindale Chardonnay 1997    ................. @   $248 dozen
$
Carindale Chardonnay 1996           ................. @   $270 dozen
$
Carindale Chardonnay 2000       

   ................. @   $226 dozen

$
Carindale Blackthorn
Cabernet Merlot Blend 1999		    ................. @   $286 dozen
$
Total Number of Bottles
To make dozen 
you need an extra
bottle(s)
SubTotal
$
Destination & Freight
 		 $
Total Amount
 $
Money back guarantee if not completely satisfied.
Payment and Shipping Information

I am over 18 years of age  
Your e-mail address:
Expiry  date
  I will pay by credit card  
 Card type:
/
       
Card Number:
   
     
Cardholder Name:
OR  I will post a cheque   
  
  
OR  (Australia only) I would prefer a telephone call to confirm
the order and provide my credit card details 		 

Your Details:  
First Name:
  
Last Name:
 
Address:
   
 
City:
  
State/Province:
  
ZIP/Postal Code: 
  
Country:
 
Phone/private:
  
Phone/work:
  
Fax:
  
Other instructions or comments:  
            

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