Wine Submission Form

Details of Wine to be Reviewed by Qantas

This Form to be completed for wine yet to be reviewed by Qantas. The information in this form will be used for selection and purchasing decisions.
*Compulsory Field
    Submission Date:
    Submission Status:* Please only select 'Replacement submission' if you have previously submitted this wine and need to change the details of your submission. This submission must be completed in full and will replace the previous submission in its entirety.
Wine Submission form ID - null
    Submission ID:
    Email ID:

Wine Details

    Wine Category:*
    Main Wine Variety:*
    Other Varieties Used in the Wine:
    Wine Name:*
    Country of Production:*
    Wine Region:*
    Carton Weight:* grams
    Release Date to the Public:*
    Total Quantity Submitted:* dozen
    Total Quantity Produced: dozen
    Net Price to Qantas:*
$A   per dozen
    Price Checklist*  
    (please tick all):
Yes, this price is in Australian dollars
Yes, this price is per dozen
Yes, this price includes Qantas labelling
Yes, this price is net of all taxes
Yes, this price is Free into Store to Sydney, Melbourne, Brisbane, Adelaide, or Perth (New Zealand wines need only be delivered to Sydney and Auckland)
    Where is this Wine Sold?:
Supermarket Bottleshops
Independent Bottleshops
Chain Bottleshops
    What is the Usual Retail Price:*
$A   per bottle

Supplier Details

    Contact Name:*
    Contact Email Address:*
    Confirm Email Address:*
This email will be used to send confirmation of offer.
    Contact Phone:*
    Supplier Name:*
    Supplier Relationship:*