WINE ORDER FORM
QTY WINE DOZ PER TOTAL
2009 Sauvignon Blanc$129.60$12.00
2008 Autumn Harvest Botrytis Chardonnay$140.00$13.00
2007 Chardonnay$151.00$14.00
2008 SUNDOWN Cabernet Merlot$264.00$22.00
2007 RESERVE Cabernet Sauvignon$295.80$29.00
2009 Delicioso$152.00$14.00
RESERVE 2003 Cabernet Sauvignon $165.00$0.00
2004 Cabernet Sauvignon$259.00$24.00
POSTAGE & HANDLING  
ORDER TOTAL

DELIVERY ADDRESS
name
street
town
state postcode
phone
fax
mobile
 
e-mail address

CREDIT CARD PAYMENT DETAIL
Credit card Type
Credit card Number
Name on card
Expiry Date

ORDER COMMENTS
MAIL/FAX ORDERS (Print this page and post/fax to the below address)
Gold Wine Sales
PO Box 278
Coonawarra SA 5263
Phone : 0417 816 075 or 0417 832 003
Fax : (08) 8728 0302
Email : accounts@goldwinesales.com.au