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Note: Be sure to use your complete email address
(e.g., username@domain.com.au)

Orders (Please enter quantities you would like):
If you want more than 10 cases, please call or e-mail us

Item (Click for description)	Number bottles	Bottle Price	Number cases	Case Price	Total
	0	$	0	$	$
	0   1 2 3 4 5 6 7 8 9 10	$	0   1 2 3 4 5 6 7 8 9 10	$	$
	0	$	0	$	$
	0   1 2 3 4 5 6 7 8 9 10	$	0   1 2 3 4 5 6 7 8 9 10	$	$
	0   1 2 3 4 5 6 7 8 9 10	$	0   1 2 3 4 5 6 7 8 9 10	$	$
	0   1 2 3 4 5 6 7 8 9 10	$	0   1 2 3 4 5 6 7 8 9 10	$	$
	0   1 2 3 4 5 6 7 8 9 10	$	0   1 2 3 4 5 6 7 8 9 10	$	$
You have ordered		bottles and		cases for	$
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There are 12 bottles in a case, and we will apply a discount of 10% on one or more cases ordered.
The minimum order for shipping is 3 bottles.
The wine is sent by registered post, and postage costs will be advised when taking payment details.

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We will contact you regarding your order on this form.