HURLEY
VINEYARD PINOT NOIR
ORDER
FORM
NAME: ............................................................................................................
ADDRESS:
.
POSTCODE
TELEPHONE: ...........................
...(H)
....
...........(B)
(Mob)
EMAIL:
SPECIFY YOUR ORDER: .
.
.............................................................
(See options below)
.
.
.
AMOUNT: $......
.
CREDIT CARD: (TICK)
VISA
...
MASTERCARD
...
BANKCARD
...
CREDIT CARD NUMBER:
.
.
EXPIRY DATE:
.
...
CHEQUE ATTACHED: (TICK) YES
.
SIGNATURE:
.
...
DATE:
.
...
PURCHASE OPTIONS: 2002 HALF CASE (6 bottles): $198.00
2001/2002 HALF CASE (3 bottles of each) $189.00
2001/2002 FULL CASE
(6 bottles of each) $360.00
2001 FULL CASE (12
bottles) $360.00
2OO2 PURCHASE LIMIT 6
bottles
Delivery is free for cases and
half cases to major centres.
SPECIAL DELIVERY
INSTRUCTIONS:
SENDING YOUR ORDER: POST: HURLEY VINEYARD
PHONE (03 5931
3000
FAX: (03) 5931 3200
EMAIL bell@hurleyvineyard.aust.com