Please print out this form, fill it in, and post it to:
Karmine Apple Juice, Moorstown, Cahir, Co. Tipperary 
 

Name

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Address

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Contact phone no.

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Please send me
...... case(s) of Karmine Apple Juice at  €35.95 each. Subtotal €...............
...... case(s) of Calcium Fortified Apple  Juice at  €44.95 each. Subtotal €...............
...... case(s) of Mixed Option 1 (Red Fruits) at  €45.95 each. Subtotal €...............
...... case(s) of Mixed Option 2 (Black and Red) at  €45.95 each. Subtotal €...............
...... case(s) of Mixed Option 3 (Red and Black) at  €43.95 each. Subtotal €...............
...... case(s) of Mixed Option 4 (All the Juices) at  €42.95 each. Subtotal €...............
...... case(s) of Unpasteurised Cider Vinegar at  €59.95 each. Subtotal €...............

(A case contains 12 bottles of 750ml each. Price includes Post & Packing.)
See website for descriptions of the various options Total €...............

I enclose a cheque (payable to Con Traas Ltd.) for the above total amount.

or

Please charge the above total amount to my credit card as follows:

VISA MASTERCARD

Card Number

 ....................................................

Expiry Date

 ....................................................

Name on Card

 ....................................................

Address of Cardholder

 ....................................................
....................................................
....................................................

Signed

 ....................................................

Date

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