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Razorback Order Form May 2016

The document is a wine order form from RPMason winery located at 20 Dawson Road, Menangle NSW 2568. It lists various sparkling wines, white wines, rosé wines and red wines available for purchase individually or in six-pack quantities. The form requests the customer provide their name, date of birth, address, phone number and payment details to complete the order.

Uploaded by

Muhammad Ikhsan
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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29 views1 page

Razorback Order Form May 2016

The document is a wine order form from RPMason winery located at 20 Dawson Road, Menangle NSW 2568. It lists various sparkling wines, white wines, rosé wines and red wines available for purchase individually or in six-pack quantities. The form requests the customer provide their name, date of birth, address, phone number and payment details to complete the order.

Uploaded by

Muhammad Ikhsan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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20 Dawson Road, Menangle NSW 2568 Phone: 0408 866129

E-mail: [email protected] Licence Number: LIQW 824013977 ABN: 83 589 317 075

Sparkling Wine
2014 Natashas Sparkling Ros
2013 Dianna Jane (Sparkling Chard)

$22 Bottle Qty _____


$22 Bottle Qty _____

$119 Six Pack Qty _____


$119 Six Pack Qty _____

White Wine
2009 Aged Unwooded Chardonnay
2014 Unwooded Chardonnay Bruno
2014 Verdelho

$18 Bottle Qty _____


$22 Bottle Qty _____
$22 Bottle Qty _____

$97 Six Pack Qty _____


$119 Six Pack Qty _____
$119 Six Pack Qty _____

Ros Wine
2014 Emilys Blush Ros

$18 Bottle Qty _____

$97 Six Pack

Qty _____

Red Wine
2013 Jordan Shiraz
2013 Cabernet Sauvignon
2014 Merlot

$22 Bottle Qty _____


$22 Bottle Qty _____
$22 Bottle Qty _____

Wine Sub Total:

$____________________________

$119 Six Pack Qty _____


$119 Six Pack Qty _____
$119 Six Pack Qty _____
$____________________________

Freight Total:
Sydney Metro / Wollongong Delivery $14.00 (incl GST ) Min 6 bottles required for delivery. Other areas please phone.

Total Price:

$____________________________

$____________________________

Please note all prices listed include GST, these prices are current at May 2016

It is against the law to sell or supply alcohol to, or obtain alcohol on behalf of, a person under the age of 18 years
Phone, fax and internet orders now require the buyer to provide their date of birth as proof they are over the age of 18.

Name:

_________________________________________________

DOB:

_________________________________________________

Address:

_________________________________________________
_________________________________________________

Phone:

Cheque

__________________ Email: ________________________

Payment Method
Money Order

Credit Card

Expiry Date:

_________________________________________
___/___

Name on Card:

_______________________

Credit Card Number:

Thank you for your custom

Signature: _____________________

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