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Name & Surname *

Company/Cellar

Email Address *

Contact Number *

Cultivar / Style & Vintage

WS/ WSB Number

Price per Litre in ZAR

Volume

Can Volume be split Please select one... Yes No

Cultivar %

Wine of Origin

IPW Please select one... Yes No

Wieta Please select one... Yes No

Organic Please select one... Yes No

If Organic which acreditation

Alcohol

Residual Sugar Range

Volitile Acidity

FSO2

TSO2

Style Please select one... Light-Bodied Medium-Bodied Full-Bodied Aromatic Complex Crisp Fruity Juicy Neutral Rich Smooth Soft Tannic Tropical

Wooded Please select one... Yes Lightly No

Filter Requirements Please select one... Bulk Filter Centrifuged Cross Flowfilterd Non Filtered

Cold Stability Please select one... Yes No NA

Protein Stability Please select one... Yes No NA

Notes, Additional Information & Requirements

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