Phone, fax, mail or email Order Form

2001 Chardonnay:  

2002 Chardonnay: 

2004 Chardonnay/Sauvignon Blanc: 

2005 Sauvignon Blanc:  

2005 Chardonnay/Sauvignon Blanc Pour Le Dessert:  

2005 Rose de Noir:  

2000 Pinot Noir:  

2002 Pinot Noir:  

2001 Shiraz: 

2003 Shiraz: 

2004 Merlot:  

Delivery: Free within Australia

Overseas: on request.

Mr/Mrs/Miss/Ms ................................................................................................

Postal Address ......................................................................................................

................................................................................... Postcode............................

Delivery Address ..................................................................................................

..................................................................................... Postcode...........................

Special Delivery Instructions ................................................................................................................................

.................................................................................................................................

Phone (H) ..............................................................................................................

Phone (W) ..............................................................................................................

Mobile ...................................................................................................................

Email ......................................................................................................................


Payment Details

Please charge my

_ Visa   _ MasterCard   _ Bankcard   _ American Express

_ _ _ _    _ _ _ _     _ _ _ _    _ _ _ _

Expiry Date _ _  / _ _

I understand that my credit card details will be treated as strictly confidential at all times by Blueberry Hill Vineyard and used only in accordance with this written authorization. I certify that I am over 18 years of age.

Cardholder’s signature ........................................................................

Cardholder’s name ..............................................................................

Date ....................................................................................................

Date of birth ........................................................................................

NB Please fax, mail or email to Blueberry Hill.

Blueberry Hill Vineyard
Cnr McDonalds & Coulson Rds
POKOLBIN NSW 2320

Phone: (02) 4998 7295

Fax: (02) 4998 7296

Email: blueberryhill@hunterlink.net.au

We therefore seek your co-operation in providing your

 date of birth in the space provided in the order form. 

This is required on your first order only after 1 July 2002 

as it will be recorded in our files for subsequent orders.

The courier delivering the wine will be advised that in 

accordance with the Liquor Act your order must be delivered:

- to another adult person at the same address who undertakes 

to accept the order on your behalf