Dionysus Winery
Order Form
Dionysus WineryOrder Form |
|
TAX INVOICE ABN: 36 583 780 692
Please complete all details, print this page from your browser and sign it.
For cheque orders, send to 1 Patemans Lane, Murrumbateman, NSW, 2582.
For credit card orders, send to the above address OR fax to (02) 6227 0209.
Name
Postal address details:
Address
Suburb/City State Postcode
Contact telephone number or email address
Delivery address details (if different from above):
Address
Suburb/City State Postcode
Payment options:
Cheque enclosed Credit card (details below)
Credit card details:
Type of card: Bankcard Mastercard Visa
Credit card number Expiry date
Name on Card Signature ______________________
| Wine | Price per bottle |
Number of bottles |
Value |
| 2008 May Riesling (Dessert Ice Wine 375ml) | $20.00 |
$ | |
| 2008 Sauvignon Blanc | $19.00 | $ | |
| 2008 Chardonnay | $20.00 | $ | |
| 2008 Maenads Rose | $18.00 |
$ | |
| 2006 Pinot Noir | $25.00 |
$ | |
| 2006 Cabernet Merlot | $22.00 |
$ | |
| 2006 Shiraz | $22.00 |
$ | |
| 2005 Cabernet Sauvignon | $22.00 |
$ | |
| Dozen discount (10%) | $ | ||
| Freight * | $ | ||
| TOTAL ORDER |
$ | ||
* Delivery within the ACT is free, otherwise delivery charges (per dozen) apply
Delivery Sydney $10, Melbourne $15, Brisbane $15, Tasmania $25, Perth $25, Adelaide $25