Mortimers of Orange Order Form

Mortimers Wines Order Form

LIQUOR ACT 1982

IT IS AN OFFENCE TO SELL OR SUPPLY TO OR TO OBTAIN LIQUOR ON BEHALF OF A PERSON UNDER THE AGE OF 18 YEARS.

Date of Birth dd/mm/yy: / /

The Wine

Quantity

Pinot/Chardonnay Sparkling Cuvee

$22.00 per bottle

$264.00 per case

Chestnut Garth Premium Chardonnay
Bronze Medal
New Zealand International Wine Show 2007

$25.00 per bottle

$300.00 per case

Autumn Series Chardonnay
Silver Medal
NSW Small Winemakers Show 2006

$15.00 per bottle

$180.00 per case

2005 Pinot Noir

$28.00 per bottle

$336.00 per case

2005 Jules* Shiraz/Cabernet
Bronze Medal
New Zealand International Wine Show 2007

$46.00 per bottle

$552.00 per case

Premium Black Label Shiraz
Bronze Medal
National Cool Climate Wine Show 2006

$28.00 per bottle

$336.00 per case

Premium SG Shiraz

$30.00 per bottle

$360.00 per case

Autumn Series Shiraz
Bronze Medal
NSW Small Winemakers Show 2006

$15.00 per bottle

$180.00 per case

The Twin Pack Autumn Series

$32.00 per pack

$180.00 mixed case

Premium Cabernet Savignon

$25.00 per bottle

$300.00 per case

Autumn Series Cabernet Sauvignon

$15.00 per bottle

$180.00 per case

Note: add $20 for freight within NSW.

Name:

Street:

City: State: P/Code:

Phone Number:

Email address:

Payment Options: COD Cheque Visa Mastercard

Card Number: Expiry Date: /

Enter your payment, whole dollars only.