Your Full Name:* First Last Address (Street/POBox):* Street Address City State Postcode Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Preferred Phone Number:*Email Address:* I'd like to:*Make a one-off purchaseSign up to the Oliver's Wine Exchange ClubOne-off purchaseSelect the pack(s) you'd like to purchase:* [Staple Shiraz] – Oliver’s Taranga Shiraz Pack $480 AUD including freight. [Tastes of Taranga] – Shiraz & Reserve Sampler Pack $513 AUD including freight. [Tried & Tested] – HJ Reserve Shiraz Pack $683 AUD including freight. [Tried & Tested] – Reserve Mix Pack $683 AUD including freight. [Iconic Oliver’s] – M53 Shiraz Six Pack Currently Unavailable Select the club pack you would like to receive:*[Staple Shiraz] – Oliver’s Taranga Shiraz Pack $480 AUD with free freight, 1 dozen delivered biannually.[Tastes of Taranga] – Shiraz & Reserve Sampler Pack $513 AUD with free freight, 1 dozen delivered biannually.[Tried & Tested] – HJ Reserve Shiraz Pack $683 AUD with free freight, 1 dozen delivered biannually.[Tried & Tested] – Reserve Mix Pack $683 AUD with free freight, 1 dozen delivered biannually.[Iconic Oliver’s] – M53 Shiraz Six Pack Currently UnavailableComments / Questions:Credit Card* American ExpressMasterCardVisa Card Number Expiration Date Month010203040506070809101112 Year20182019202020212022202320242025202620272028202920302031203220332034203520362037 Security Code Cardholder Name Declaration I subscribe to be an Oliver’s Wine Exchange Club member. I understand the obligations of the Oliver’s Wine Exchange Club membership and seek to have the selected number of wines sent to an address nominated by myself bi-annually or until I cancel my membership by email or in writing. These orders are not to be purchased for resale by a liquor licensed person or their representative. Liquor Act 2007 – It is an offence to sell or supply to or obtain liquor on behalf of a person under the age of 18 years.Authorisation* I authorise Oliver’s Taranga Vineyards to debit my credit card with the appropriate sum on dispatch of wine. CommentsThis field is for validation purposes and should be left unchanged.