ZIMMERMANN WINE
order form
prices per bottle
Vintage
|
Price/bottle |
Quantity |
total |
|
Zimmermann Shiraz 2007 |
$ 29.00 |
_______ |
$_____________ |
|
Zimmermann Shiraz 2006 |
$ 36.00 |
_______ |
$_____________ |
|
Total Amount : |
$_____________ |
prices per dozen
Vintage
|
Price/dozen |
Quantity |
total |
|
Zimmermann Shiraz 2007 |
$ 319.00 |
_______ |
$_____________ |
|
Zimmermann Shiraz 2006 |
$ 396.00 |
_______ |
$_____________ |
|
Total Amount : |
$_____________ |
delivery
details
|
Your
Name : |
_________________________________________________ |
|
Address : |
_________________________________________________ |
| |
_________________________________________________ |
|
State / Postcode : |
_________________________________________________ |
|
Phone No.: |
_________________________________________________ |
payment
details
|
Cheque ___ / Money order ___ / Master Card
___ / Visa Card ___ |
|
Card
No: |
_ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ |
|
Expiry Date : |
__
__ / __ __ |
|
Name
on Card : |
_________________________________________________ |
Signature : |
_________________________________________________ |
Freight free delivery within Australia for a dozen only
Enquire to be a member of our Wine Club
Please print
and fill out the wine order form
Fax this
form to : +61 (0)8 8556 4078
Click here to open
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|
