To join the wine club please print this page and fax it to 02 4998 7430

Yes, I agree to receive the Biannual Premiers Selection Tasting Half Dozen
I reserve the right to cancel my membership within 14 days notice in writing

Name  
Street
Town
State
Postcode
Contact Phone
Business hours phone
E-mail
Delivery address
Delivery instructions

I agree to have $108.00 plus $7.00 freight deducted from my credit card at shipping of each half dozen.

Please deduct the amount from my credit card 
(Amex / Diners / Visa / MasterCard)
Credit Card type
Card Number
Expiry date
Amex security number
Signature