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

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

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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

Payment Method

Select One

Your Credit Card Details

Type of Card

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.