LA CANTINA
KING VALLEY

54 Honey's Lane,
King valley, Victoria, 3678
Australia
Ph. (03) 5729 3615    Fax. (03) 5729 3613
Email: lacantina@lacantinakingvalley.com.au

Order Form

Prices and availability as of April 2008

Wine & Price per bottle

Qty.

Sub Total

Order total:

Freight:

TOTAL:

Freight charges per case.
Melbourne: $8.00  Brisbane: $28.00   
Sydney & Adelaide: $20.00
Perth $35.00
For other areas please enquire. Ph. (03)57293615

Name:

Address:

City:

State:

Country:

Post Code:

Phone:

Payment Method:

Please print Order Form
and either
mail or fax it to us.

Select 
File, Print,
and select page 1
to print order form.

Cheque enclosed

MasterCard

Diners Club

Visa

Date:

Name on Card

Exp. Date:

Credit Card #:

Signature:

"We thank you for buying our wines and hope you enjoy our product."