[ Home ]
Order Form
Fill in quantities required below then return to :
Clayfield Wines fax 53542679 or mail to 25 Wilde Lane Moyston VIC. 3377 or
email at : sales@clayfieldwines.com.au
Grampians Shiraz 2004 @ $ 150.00 per bottle ______________
Grampians Shiraz 2008 @ $ 65.00 per bottle ______________
Massif Shiraz 2009 @ $ 30.00 per bottle ____________
Thomas Wills Shiraz NV @ $ 35.00 per bottle ____________
Sub-Total ______________
Add $15.00 per carton for delivery ______________
Total ______________
Method of Payment : Cheque / Credit Card
Card number ____________________ Expiry date ____________________
Phone number ____________________ Signature ____________________
Delivery address _______________________________________________________________________________
Special instructions ____________________________________________________________________
License number 32450617
" WARNING Under the Liquor Control Reform Act 1998 it is an offence
to supply alcohol to a person under the age of 18 years (Penalty exceeds $6000)
for a person under the age of 18 years to purchase or receive liquor (Penalty exceeds $500)."
eftpos available