MUSEUM WINES: Order Form

This series of wines was made between 1990 and 1996 and are available through this form by the dozen only. Pricing is calculated at 12 bottles for the price of 11. These were wax sealed over the original cork and drawn from temperature controlled storage. Fill levels are good with every bottle sold.

David (Consultant) and Tim (Winemaker) evaluate a wine in the private cellar.

WINE #3, Bottled 1993

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DELIVERY METHOD
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PAYMENT METHOD
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BLACK STUMP WINES EFT or CASH DEPOSIT:

Account No: 065-126 1006 7930

REFERENCE: Full Name

Wine despatched on receipt of payment.

FOR HOME OR BUSINESS DELIVERY AND PAY LATER BOTH AN EMAIL ADDRESS AND PHONE NUMBER ARE REQUIRED.

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FOR COUNTRY DELIVERIES, IF A QUOTATION IS REQUIRED TEXT AS FOLLOWS;

"MUS + NAME + POSTCODE + NUMBER OF BOTTLES" or Submit Form at Right.

https://www.cognitoforms.com/BlackStumpWinesBlackStumpWines/Delivery

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Delivery may be withheld in the event of extreme weather conditions at the point of despatch or receival until conditions improve.
Authority to Leave
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Wine will not be left in warm or hot weather or when security is in doubt. A business hours office delivery is recommended.
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PAY NOW: MUSEUM WINES

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PAY LATER: MUSEUM WINES

Item {binding ItemNumber}

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{binding Name}:{binding displayValue}---
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MUSEUM WINES: Order Form

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{{ Cognito.resources['order-amount-paid'] }}:({binding displayValue})
{{ Cognito.resources['order-balance-due-label'] }}:{binding displayValue}

David (Consultant) and Tim (Winemaker) evaluate a wine in the private cellar.

WINE #3, Bottled 1993

Name
{binding displayValue}
DELIVERY METHOD
{binding displayValue}
PAYMENT METHOD
{binding displayValue}

BLACK STUMP WINES EFT or CASH DEPOSIT:

Account No: 065-126 1006 7930

REFERENCE: Full Name

Wine despatched on receipt of payment.

FOR HOME OR BUSINESS DELIVERY AND PAY LATER BOTH AN EMAIL ADDRESS AND PHONE NUMBER ARE REQUIRED.

EMAIL: For Electronic Confirmation of Order (Recommended)
{binding displayValue}
MOBILE or Other Phone (Text Notification of Delivery or Ready for Collection)
{binding displayValue}

FOR COUNTRY DELIVERIES, IF A QUOTATION IS REQUIRED TEXT AS FOLLOWS;

"MUS + NAME + POSTCODE + NUMBER OF BOTTLES" or Submit Form at Right.

https://www.cognitoforms.com/BlackStumpWinesBlackStumpWines/Delivery

Shipping Address
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Authority to Leave
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Instructions / Comments / Queries

PAY NOW: MUSEUM WINES

Item {binding ItemNumber}

CHOOSE WINE @ $95ea. 12 for 11, 750ml
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HOW MANY DOZEN?
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TOTAL THIS WINE
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PAY LATER: MUSEUM WINES

Item {binding ItemNumber}

CHOOSE WINE @ $95ea. 12 for 11, 750ml
{binding displayValue}
HOW MANY DOZEN PAY LATER?
{binding displayValue}
TOTAL THIS WINE
{binding displayValue}
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MUSEUM WINES: Order Form

This series of wines was made between 1990 and 1996 and are available through this form by the dozen only. Pricing is calculated at 12 bottles for the price of 11. These were wax sealed over the original cork and drawn from temperature controlled storage. Fill levels are good with every bottle sold.

{{ Cognito.resources['order-transaction-details-header'] }}

{{ Cognito.resources['order-number-label'] }}: {binding displayValue}
{{ Cognito.resources['order-date-label'] }}: {binding displayValue}
{{ Cognito.resources['order-method-label'] }}: {binding MethodReference}

{{ Cognito.resources['order-billing-info-header'] }}

{binding BillingName}
{binding BillingAddress.FullInternationalAddress}
{binding PhoneNumber}
{binding EmailAddress}
{binding Group}
{binding Name} - {binding Description}{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}{binding displayValue}
{{ Cognito.resources['order-total-label'] }}: {binding displayValue}
{{ Cognito.resources['order-amount-paid'] }}:({binding displayValue})
{{ Cognito.resources['order-balance-due-label'] }}:{binding displayValue}

David (Consultant) and Tim (Winemaker) evaluate a wine in the private cellar.

WINE #3, Bottled 1993

Name
{binding displayValue}
DELIVERY METHOD
{binding displayValue}
PAYMENT METHOD
{binding displayValue}

BLACK STUMP WINES EFT or CASH DEPOSIT:

Account No: 065-126 1006 7930

REFERENCE: Full Name

Wine despatched on receipt of payment.

FOR HOME OR BUSINESS DELIVERY AND PAY LATER BOTH AN EMAIL ADDRESS AND PHONE NUMBER ARE REQUIRED.

EMAIL: For Electronic Confirmation of Order (Recommended)
{binding displayValue}
MOBILE or Other Phone (Text Notification of Delivery or Ready for Collection)
{binding displayValue}

FOR COUNTRY DELIVERIES, IF A QUOTATION IS REQUIRED TEXT AS FOLLOWS;

"MUS + NAME + POSTCODE + NUMBER OF BOTTLES" or Submit Form at Right.

https://www.cognitoforms.com/BlackStumpWinesBlackStumpWines/Delivery

Shipping Address
{binding displayValue}
Authority to Leave
{binding displayValue}
Instructions / Comments / Queries

PAY NOW: MUSEUM WINES

Item {binding ItemNumber}

CHOOSE WINE @ $95ea. 12 for 11, 750ml
{binding displayValue}
HOW MANY DOZEN?
{binding displayValue}
TOTAL THIS WINE
{binding displayValue}
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PAY LATER: MUSEUM WINES

Item {binding ItemNumber}

CHOOSE WINE @ $95ea. 12 for 11, 750ml
{binding displayValue}
HOW MANY DOZEN PAY LATER?
{binding displayValue}
TOTAL THIS WINE
{binding displayValue}
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