Wine order form

Wine order form
Snowy River Winery
Jindabyne Rd, Berridale, 2628 NSW Australia
Tel: 1300 138812 Fax: (02) 6456 4036

Print out order form, complete order - (include credit card details or cheque).
After completion, fax or post to: PO Box 68 Berridale NSW 2628.

First name:

Last name:

Street address:

Town/suburb:

State & postcode:

Telephone:

Fax:

Email:

Type of credit card (Visa, Mastercard, Bankcard & Amex):

Credit card number:

Name on credit card:

Expiry date:

Type and quantity of wine required - (*all prices include 10% GST)
Available Wine Varieties (all prices include 10% GST) (*all wine sold by the carton, 12 bottles per carton)	Per bottle	Bottle quantity	Total amount
1998 Alpine Dry White	$13.50
1999 Sauvignon Blanc / Chardonnay	$14.50
2000 Sieger Riebe	$15.50
1999 Sylvaner/Mueller Thurgau	$14.50
1996 Noble Riesling	$16.50
2000 Snow Bruska	$14.50
1998 Snowy White	$14.50
Wine total
Total amount owing