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

Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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DELIVERY METHOD {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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PAYMENT METHOD {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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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

Shipping Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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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 {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }

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

Item {binding ItemNumber}

{ binding firstError.message }
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{ binding firstError.message }

PAY LATER: MUSEUM WINES

Item {binding ItemNumber}

{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }
{ binding firstError.message }

{~ Payment_Block_Label}

{binding Group}
{binding Name} - {binding Description}{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}{binding displayValue}
{binding Name}:{binding displayValue}---
{{ Cognito.resources['payment-amount-due'] + ":" }} {binding displayValue}

MUSEUM WINES: Order Form

{{ 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 {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
DELIVERY METHOD {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
PAYMENT METHOD {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

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) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
MOBILE or Other Phone (Text Notification of Delivery or Ready for Collection) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

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 {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Authority to Leave {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Instructions / Comments / Queries {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }

PAY NOW: MUSEUM WINES

Item {binding ItemNumber}

CHOOSE WINE @ $95ea. 12 for 11, 750ml {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
HOW MANY DOZEN? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
TOTAL THIS WINE {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
{ binding firstError.message }

PAY LATER: MUSEUM WINES

Item {binding ItemNumber}

CHOOSE WINE @ $95ea. 12 for 11, 750ml {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
HOW MANY DOZEN PAY LATER? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
TOTAL THIS WINE {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
{ binding firstError.message }

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 {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
DELIVERY METHOD {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
PAYMENT METHOD {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

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) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
MOBILE or Other Phone (Text Notification of Delivery or Ready for Collection) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }

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 {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Authority to Leave {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
Instructions / Comments / Queries {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{ binding firstError.message }

PAY NOW: MUSEUM WINES

Item {binding ItemNumber}

CHOOSE WINE @ $95ea. 12 for 11, 750ml {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
HOW MANY DOZEN? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
TOTAL THIS WINE {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
{ binding firstError.message }

PAY LATER: MUSEUM WINES

Item {binding ItemNumber}

CHOOSE WINE @ $95ea. 12 for 11, 750ml {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
HOW MANY DOZEN PAY LATER? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
TOTAL THIS WINE {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
{binding displayValue}
{ binding firstError.message }
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