ORDER FORM To place an order please fill in the following form. On receipt of your order Delacolline Wines will contact you to arrange for payment. Please contact Delacolline Estate Wines if you have any queries.

Full Name  * Postal    Delivery Address   City  * State Post Code Country  * Phone Fax Email Varieties Bottles Dozen   Donington Red 2001     bottle/$22.00 dozen/$252.00   Donington Red 1999     bottle/$24.00 dozen/$270.00   Riesling 2003      bottle/$16.50 dozen/$182.00   Chardonnay 2003       bottle/$21.00 dozen/$235.00   Chardonnay 1997   bottle/$23.50 dozen/$260.00   Sauvignon Blanc Semillon  2004   bottle/$23.00 dozen/$264.00   Mixed dozens are welcomed   Please calculate amount owing   $???:00 Please note Freight costs are extra On confirmation of your order Delacolline Wines will contact you with the total amount owing and will process payment of your order.   Further details if necessary