ORDER FORM

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


Toute commandNo order is accepted without payment.
Possibility to mox bottles in boxes of 6 or 12.



 

Amount :

Bottle :

Price per bottle incl. tax

Total :

Duc d'Istrie        

1995

1992

Château Les Grauzils        

1996

1995

1994

Wood boxes

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 :


Potscode :
Town :
Tel. :
Fax :


Delivery details :

 

DatePreferred delivery date :

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

Delivery conditions :


Method of payment :

 
 By cheque made payable to Château Les Grauzils.

 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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