Application Type

Application -Please Select- New Client New User under an existing client

Personal Details

Registered Company Name (if applicable)

First Name

Last Name

Email

Confirm Email

Cell

Telephone It is highly recommended to supply two contact numbers to ensure the best possible service

Preferred Pickup Location: -Preferred Pickup Location- Allee Bleue Cabriere Chamonix Dieu Donne Eikehof Franschhoek Cellar Grande Provence L'Ormarins La Motte Rickety Bridge Rupert & Rothschild Tokara Pam Golding Peter Falke Botrivier Minimark Hermanuspietersfontein Paul Cluver Waterkloof Bon Courage Botha Wynkelder Clairvaux De Wetshof Du Toitskloof Mountain Ridge Nuwehoop (Uniwines) Overhex Rooiberg GEOSS Bellevue Leeuwenkuil Quoin Rock Villiera CDS - 09:00 CDS - 14:00 DGB - 09:00 DGB - 14:00 Laffort - 09:00 Laffort - 14:00 Perdeberg - 09:00 Perdeberg - 14:00 Proxa Windmeul - 09:00 Windmeul - 14:00

Preferred Communication:

Email SMS

Physical Address

City/Town

Zip Code

Billing Information (if applicable)

VAT Number

Contact Person

Email

Confirm Email

Preferred Invoice Format:

Individual invoice (per sample) Grouped invoice

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Terms and Conditions

The results of tests will be handled with absolute confidentiality by Vinlab, however due to our status of Accredited Laboratory the results have to be made available to SANAS and other legal parties on request.

I hereby accept these terms and conditions