Aan de Doorns Order Form

Please complete the form to place an order.

Please note that this is a secure form and all details are e-mailed to Aan de Doorns exclusively.

Prices valid from January 2009

All prices in South African Rand.

Item    Description Price per bottle Price per Case (6 Bottles per case) Quantity (Cases) 1 Chenin Blanc 2010 R20.00 R 2 Sauvignon Blanc 2010 R24.00 R 3 Colombar 2010 R20.00 R 4 Blanc De Noir 2010 R20.00 R 5 Demi-Sec Sparkling Wine R32.00 R 6 Doornroodt 2008 R24.00 R 6 Pinotage 2009 R30.00 R 8 Muskat 'D Alexandrie 2009 R30.00 R 9 Red Muskadel 2009 R32.00 R 10 Cape Ruby 2008 (port) R32.00 R 11 White Grape Juice (12x750ml) R12.00 R 12 Red Grape Juice (12x750ml) R12.00 R 13 White Grape Juice (500ml) R 6.25 R (1 Bottle) 14 Red Grape Juice (500ml) R 6.25 R (1 Bottle) 15 Dry White Bag in Box R45.00 R (1 Box) 16 Dry Red Bag in Box R50.00 R (1 Box)

~Courier costs are not included~

Please note that transport cost will be calculated according to courier fees and added to the total amount. The total amount will be confirmed as soon as we have received your order then Aan de Doorns will send you the complete invoice. Deliveries only within the borders of South Africa. **International orders will be shipped only after the costs have been verified with the client.

Client Details

Please complete the form below.

Titel: Mr Mrs Miss Dr Prof Initials: Name: Surname: Address: Delivery Address: Courier:  Yes No Country: South Africa -------------- Australia Austria Belgium Canada Denmark Finland France Germany Greece Holland Hong Kong Ireland Israel Italy Japan Netherlands New Zealand Norway Portugal Singapore South Africa Spain Sweden Switzerland Taiwan United Kingdom U.S.A Tel: Fax: Cell: Email: Extra Detail: