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GREAT LAKES WINES - ORDER FROM
115 Herivels Road, Wootton, 2423 Phone: (02) 49977255 Fax: (02) 49977450 Email: wine4me@greatlakeswines.com.au
       
Variety Case Price Qty Total
pricing applies to any straight or mixed doz      
       
Sparkling Lily NV $18.00    
Mellow White $18.00    
Verdelho 2011 $18.00    
Dragonfly Rose 2010 $18.00    
Merlot 2010 $18.00    
Water Lily Dessert Wine $18.00    
Tawny Port $18.00    
       
Delivery fees: $18.00 NSW Coast/$20.00 Country/ $25.00 Interstate
Great Lakes Wine Club members receive 13 to the Dozen plus Free Delivery    
  TOTAL    
       
DELIVERY DETAILS: (please print)      
       
First Name: Last Name:    
       
Street Address: (no P.O. Boxes for delivery purposes)      
       
       
       
Suburb: State: Postcode:  
       
Telephone: (H) (W)    
       
Email:   Great Lakes Wine Club Member: YES / NO
       
Please advise any special delivery instructions if nobody there to accept delivery:
       
PAYMENT DETAILS:      
Please debit my credit card/find cheque enclosed (please make cheques payable to Great Lakes Wines)
       
Mastercard/VISA Amount:$    
       
Card #: Expiry date:    
       
Signature: Dated:    
       
Name on the card:      
       
*Pricing applicable as of April 2011- pricing and range will vary over time
     
FAX OR EMAIL COMPLETED FORM - SEE DETAILS TOP OF PAGE
Great Lakes Wines 2008