Order form

Prices in euros (including all taxes)

Vin Paillé white or red

Prices as of December 1, 2008

Vintage	per bottle	per bottle for 2 bottles	per bottle for 6 bottles
2006	18,00	17,50	17,00
2005	19,00	18,50	18,00
2004	20,00	19,50	19,00

Nut oil: 10€ /bottle
Nut wine : 12€ /bottle
(Professionals: contact us; you will be offered prices according to the number of ordered bottles.)

Port Colissimo packing (present price at la Poste) :
2 bottles: 10,50 € 3 bottles: 12,40 € (Contact us for larger quantities.)

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Please print and fill the following order form and mail it, together with your payment, to:

Jean Louis Roche
Domaine du Bas Queyssac
19120 Queyssac les Vignes
France

You order will be sent within five days of the reception of your order and payment.

Don't forget to mention here vintage you wish to order:


Nb of bottles of white Vin Paillé:  Price per bottle: Amount:   (1)
Nb of bottles of red Vin Paillé:  Price per bottle: Amount:   (2)
Nb of bottles of nut oil:  Price per bottle:     Amount:    (3)
Nb de bottles of nut wine:   Price per bottle:     Amount:    (4)
                                 
                                                       Total (1)+(2)+(3)+(4) 
                                                              Transport charges  
                                                       TOTAL for this order

Please write down your address below:

Name :

First name :

Address :



E-mail address :

Return to the home page: The Vin paillé of the Domaine du Bas Queyssac

jeanlouisroche@orange.fr
Telephone: 05 5591 0521 Mobile phone: 06 8345 9442
http://domainedubasqueyssac.com/