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Pancake Estate Wines - Order Form
Your Name
(First Name/Last Name
)
Email:
Phone Number inc Area Code:
Mobile Number:
Address:
Suburb:
State:
Post Code:
Wine Order Required
2007 Unwooded Semillon $96.00 (12 bottles) inc GST
Number of Cases
1
2
3
4
5
6
7
8
9
10
2004 Shiraz $132.00 (12 bottles) inc GST
Number of Cases
1
2
3
4
5
6
7
8
9
10
Other Comments:
Following receipt of your order, a representative of Pancake Estate Wines will contact you to discuss delivery and payment.
Room 204
Epworth Building
33 Pirie St
Adelaide, SA 5000
Phone: (08) 8212-3706
Mobile: 0408 088 015
Fax: (08) 8211-6678
International Fax: 618 8211-6678
Email:
diana@pancakeestatewines.com.au
Pancake Estate Wines - Order Form