See "How to Order" to fill out form. USE BLACK PEN. INCLUDE POSTAL CODE
FAX TO Auziewines in Europe @  (03) 9574 8900 or  International +  613 9574 8900
I wish to order the following wines for my friends or corporate clients in Europe/UK: 

Purchase With: Product Number Description No of Bottles Bottle Price Total Price

 

 MASTERCARD          

 

 VISA          

 

 BANKCARD          

 

 DINERS CLUB          

 

 AMEX          

 

 CHEQUE          
Card No:   ________ ________ ________ ________      
Expiry Date:   ______/______      
Signature:

Quick Pick Selection (Include Name):

  

Subtotal:

  

10% Wine Society Discount Membership No:

  

Sub-Total:

  

Delivery:

  

Total Amount Payable

  
DELIVER TO Name:    FROM Sender's Name:
    
 Address:

  

  

    

 Address:
 
 
 
POSTCODE: POSTCODE:
Phone: Fax:  Phone: Fax:
 BELOW ARE MY PERSONAL GREETINGS TO MY FRIENDS: