Unit 8/103 Glenwood Drive   PO Box 255  Thornton NSW 2322

P: 02 4966 4933  M: 0408 490 904  F: 02 4966 5488
E: enquire@uniquexposure.com.au

Off Licence (Retail): 24014457
Liquor Licensing Act 1997It is an offence to sell or supply liquor to a person under the age of 18 years, or to obtain liquor on behalf of a person under the age of 18 years.
No, I am NOT over 18 years of age:
Yes, I AM over 18 years of age:

Ordered By

Your Name:
Address Line 1:
Address Line 2:
State: Postcode:
Contact No:
Mobile No:
Email Address:

Deliver To

If you wish to pick up your order contact Unique Exposure on 02 4966 4933.

Same name and address as above
Name:
Address Line 1:
Address Line 2:
State: Postcode:
Contact No:
Mobile No:
Email Address:

Wine Order

ItemQuantityUnit PriceAmount
Carton 6 Chardonnay & 6 Shiraz$160.00
Carton 12 Chardonnay$160.00
Carton 12 Shiraz$160.00
Tawny Port (1 bottle)$20.00
Timber Display Box$15.00
Sub-total
Postage
Total

Payment

Credit Card
Mastercard
Visa
Direct Deposit

Greater Building Society, BSB 637000, Account No. 163374905
Account Name Unique Exposure

Please use your surname as the reference on your deposit.

Delivery NSW, Qld, Vic, SA Port $10.00 per bottle Wine $15.00 per carton

WA, NT, Tas Port $12.00 per bottle Wine $30.00 per carton

Unique Exposure
8/103 Glenwood Drive,
PO Box 3255, Thornton NSW 2322
02 4966 4933 0408 490 904
petah@uniquexposure.com.au
www.uniquexposure.com.au
Liquor License No. 24014457
ABN 96 168 305 339