ORDER FORM

To be printed out and returned with your cheque or postal order.
Can be sent by E-mail if paying by credit card.

No order is accepted without payment.
Possibility to mix bottles in boxes of 6 or 12.

Amount :

Bottle :

Price per bottle incl. tax :

Total :

Château La Caminade

1995

Château La Caminade
La Commandery

1994

1995

Frais de port :

TOTAL AMOUNT OF MY ORDER :

Address for bill to be sent to:

Delivery address :

Mr                 Mrs             Ms
Name:
First name:
Address :

Postcode :
Town :
Tel. :
Fax :
Mr   Mrs     Ms
Name:
First name :
Address :

Postcode :
Town :
Tel. :
Fax :

Delivery details :

Date de livraison souhaitée :

Please inform me of the delivery at the following telephone number :

Delivery conditions :

Method of payment:

By cheque made payable to
    Château La Caminade.

By postal order

By credit card
(with the sign CB) .................... Card number:
Expiry date :

Available soon: safe payment by credit card, courtesy of the Banque Populaire du Quercy et de l'Agenais.

Any comments:

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	Amount :	Bottle :	Price per bottle incl. tax :	Total :
Château La Caminade
1995
Château La Caminade La Commandery
1994
1995

Address for bill to be sent to:	Delivery address :
Mr Mrs Ms Name: First name: Address : Postcode : Town : Tel. : Fax :	Mr Mrs Ms Name: First name : Address : Postcode : Town : Tel. : Fax :

Delivery details :
Date de livraison souhaitée :
Please inform me of the delivery at the following telephone number :
Delivery conditions :

Method of payment:
By cheque made payable to Château La Caminade. By postal order
By credit card (with the sign CB) ....................	Card number: Expiry date :