ORDER FORM
YOUR NAME & ADDRESS
Your Name
Your Address
Street Town/City
County/State Country/Postcode
Telephone EMAIL ADDRESS
WRITE YOUR MESSAGE HERE
FIRST MESSAGE
1ST LINE OF MESSAGE (22 Large characters or 33 Small)
2nd LINE OF MESSAGE (22 Large characters or 33 Small)
WINE R1>CABERNET SAUVIGNON V.D.P. £17.95 R2>MERLOT - CHILE £19.50 R3>BORDEAUX AC. - FRANCE £19.95 R4>SHIRAZ-CABERNET- AUSTRALIA £20.95 R5>RIOJA-SPAIN £21.95 R6>BOURGOGNE PINOT NOIR FRANCE £23.95 R7>BEAUJOLAIS VILLAGES - FRANCE£22.95 R8>CHATEAU BOTTLED ST. EMILION £23.95 W1>CHARDONNAY VDP - FRANCE £17.95 W2>MUSCADET-FRANCE £19.95 W3>SAUVIGNON BLANC CHILE £19.95 W4>SEMILLON CHARDONNAY AUSTRALIA £21.95 W5>BOURGOGNE BLANC FRANCE £22.95 W6>CHARDONNAY - SOUTH AFRICA £23.49 W9>MOSEL RIESLING £19.95 W7>SANCERRE - FRANCE. £23.95 W8>CHABLIS - FRANCE £24.95 C1>FRENCH SPARKLING BRUT-FRANCE £18.00 C2>AUSTRALIA - SPARKLING BRUT £19.75 C3>CREMANT DE BOURGOGNE - FRANCE £22.95 C4>CHAMPAGNE £29.95 S1>WHISKY £26.95 S2>PORT L.B.V. £26.95 S3>COGNAC SELECTION. £29.95 No BOTTLES 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120
SEND THIS BOTTLE TO NAME
Address
Street Town/City County/State
Country/Postcode DELIVERY INSTRUCTIONS
DELIVERY (NORMAL 7-10WORKING DAYS )EXPRESS WITHIN 5 WORKING DAYS AN EXTRA £2.50 PER BOTTLE) NORMAL 7-10 DAYS EXPRESS WITHIN 5 DAYS
SECOND MESSAGE
THIRD MESSAGE
WINE CHOOSE YOUR WINE HERE R1>CABERNET SAUVIGNON V.D.P. £17.95 R2>MERLOT - CHILE £19.50 R3>BORDEAUX AC. - FRANCE £19.95 R4>SHIRAZ-CABERNET- AUSTRALIA £20.95 R5>RIOJA-SPAIN £21.95 R6>BOURGOGNE PINOT NOIR FRANCE £23.95 R7>BEAUJOLAIS VILLAGES - FRANCE£22.95 R8>CHATEAU BOTTLED ST. EMILION £23.95 W1>CHARDONNAY VDP - FRANCE £17.95 W2>MUSCADET-FRANCE £19.95 W3>SAUVIGNON BLANC CHILE £19.95 W4>SEMILLON CHARDONNAY AUSTRALIA £21.95 W5>BOURGOGNE BLANC FRANCE £22.95 W6>CHARDONNAY - SOUTH AFRICA £23.49 W9>MOSEL RIESLING £19.95 W7>SANCERRE - FRANCE. £23.95 W8>CHABLIS - FRANCE £24.95 C1>FRENCH SPARKLING BRUT-FRANCE £18.00 C2>AUSTRALIA - SPARKLING BRUT £19.75 C3>CREMANT DE BOURGOGNE - FRANCE £22.95 C4>CHAMPAGNE £29.95 S1>WHISKY £26.95 S2>PORT L.B.V. £26.95 S3>COGNAC SELECTION. £29.95 No BOTTLES 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120
FORTH MESSAGE
WINE CHOOSE YOUR WINE HERE R1>VIN DE PAYS ROUGE £17.95 R2>MERLOT - CHILE £19.50 R3>BORDEAUX AC. - FRANCE £19.95 R4>SHIRAZ-CABERNET- AUSTRALIA £20.95 R5>RIOJA-SPAIN £21.95 R6>BOURGOGNE PINOT NOIR FRANCE £23.95 R7>BEAUJOLAIS VILLAGES - FRANCE£22.95 R8>CHATEAU BOTTLED ST. EMILION £23.95 W1>CHARDONNAY VDP - FRANCE £17.95 W2>MUSCADET-FRANCE £19.95 W3>SAUVIGNON BLANC CHILE £19.95 W4>SEMILLON CHARDONNAY AUSTRALIA £21.95 W5>BOURGOGNE BLANC FRANCE £22.95 W6>CHARDONNAY - SOUTH AFRICA £23.49 W9>MOSEL RIESLING £19.95 W7>SANCERRE - FRANCE. £23.95 W8>CHABLIS - FRANCE £24.95 C1>FRENCH SPARKLING BRUT-FRANCE £18.00 C2>AUSTRALIA - SPARKLING BRUT £19.75 C3>CREMANT DE BOURGOGNE - FRANCE £22.95 C4>CHAMPAGNE £29.95 S1>WHISKY £26.95 S2>PORT L.B.V. £26.95 S3>COGNAC SELECTION. £29.95 No BOTTLES 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120
ORDER TOTAL
Please debit my Credit Card/Switch
Card No Expires 04/07 05/07 06/07 07/07 08/07 09/07 10/07 11/07 12/07 01/08 02/08 03/08 04/08 05/08 06/08 07/08 08/08 09/08 10/08 11/08 12/08 01/09 02/09 03/09 04/09 05/09 06/09 07/09 08/09 09/09 10/09 11/09 12/09 01/10 02/10 03/10 04/10 05/10 06/10 07/10 08/10 09/10 10/10 11/10 12/10 01/11 02/11 03/11 04/11 05/11 06/11 07/11 08/11 09/11 10/11 11/11 12/11 01/12 02/12 03/12 04/12 05/12 06/12 07/12 08/12 09/12 10/12 11/12 12/12 01/13 02/13 03/13 04/13 05/13 06/13 07/13 08/13 09/13 10/13 11/13 12/13 01/14 02/14 03/14 04/14 05/14 06/14 07/14 08/14 09/14 10/14 11/14 12/14 Issue No(Switch)
Please ENTER 3 DIGIT SECURITY NUMBER ON FRONT OF CARD
(last three digits)
If paying by cheque send to Designer Wines Kensington Wine Warehouse,London Road, Bath, N.E.Somerset BA1 6AW with printed copy of this order form,or you can fax this order form with your credit/debit card details to 01225337181
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