ORDER

To place an order, please complete the following, print out and fax through on (08) 8379  0596 or post to PO Box 371, Glenside SA 5065.

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Vintage Variety Price
per Bottle 		Quantity
per Bottle 		Price
per Dozen 		Quantity
per Dozen		 Total
2005 Sauvignon Blanc $20.00
$240.00
2006 Sauvignon Blanc $20.00 $240.00
2005 Chardonnay $20.00 $240.00
2006 Chardonnay $20.00 $240.00
2006 Riesling $20.00 $240.00
2005 Rose $20.00 $240.00
2006 Rose $20.00 $240.00
2004 Cabernet $25.00 $300.00
2005 Cabernet $25.00 $300.00
2004 Shiraz $25.00 $300.00
2006 Fingers Crossed Red $15.00 $180.00
2006 Fingers Crossed White $15.00 $180.00
  * all prices inc GST  
          Sub Total
          Freight
          Total
Delivery Details ( For delivery price quotes please contact our office)
Name
Delivery Address
  *Please note: Wine will not be left unattended - please provide address for business hours delivery
Email Address
Telephone
Payment Details
Cheque - find enclosed (please make payable to Marlargo Wines)
Money Order - find enclosed (please make payable to Marlargo Wines)
Credit Card - see details below
 
Card Name
Card Number
Expiry Date
   
Signature _______________________________________  

 

  
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