Printable Order Form

To order within Australia, please fill out the form below and return via fax or post or post to:
Salitage Wines, Vasse Highway, Pemberton WA 6260
Phone: +61 8 9776 1195 - Fax: (61)-8-9776-1504 - Email: salitage@salitage.com.au
For international orders please contact us directly.
Your order will be shipped as soon as possible! Please allow up to 28 days for delivery.

Personal / Delivery Details

First Name

Surname

Address

Suburb

State

Postcode

Telephone

Fax

Your Order (All prices are inclusive of 10% GST)

Salitage Chardonnay 2012 Per Case: $360.00 $0.00

Salitage Unwooded Chardonnay 2012 Per Case: $204.00 $0.00

Salitage Sauvignon Blanc 2012 Per Case: $228.00 $0.00

Salitage Chardonnay 2009 Per Case: $360.00 $0.00

Salitage Pinot Noir 2009 Per Case: $420.00 $0.00

Salitage Pemberton 2007 Per Case: $330.00 $0.00

Treehouse Sauvignon Blanc 2012 Per Case: $204.00 $0.00

Treehouse Pinot Noir 2010 Per Case: $228.00 $0.00

Treehouse Chardonnay 2008 Per Case: $180.00 $0.00

Treehouse Shiraz 2007 Per Case: $228.00 $0.00

Treehouse Cabernet Sauvignon Merlot 2007 Per Case: $228.00 $0.00

SUBTOTAL: $0.00

Please calculate your shipping based on the following rates:: Perth Metro - $5.00 per case; Brisbane, Adelaide, Sydney, Canberra and Melbourne - $18 first case, $7 for each thereafter; All other Australian Locations - $25 first case, $15 for each thereafter

Shipping:

GRAND TOTAL:

Payment Method

Select One Credit Card Cheque Money Order

Your Credit Card Details

Name On Card

Type of Card Visa MasterCard BankCard American Express

Expiry

Number on Card

3/4 Digit Card Verification Code (CVC)

For American Express, this is a four-digit code found on the front of the card. For MasterCard and Visa, it is the last three numbers that are displayed on the signature panel on the back of your credit card.

Signature

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Printable Order Form