Name #1 (Dominant name on account) *

First & Last of All Parties Associated with the Membership First 1 Last 1, First 2 Last 2

First Name

Last Name

Primary Phone Number *

(###)

###

####

Second name to associate with account

Typically a spouse, life partner, roommate, bestie, drinking buddy, etc.

First Name

Last Name

Membership Level *

# Bottles, Discount, Total Annual Bottles 4, 10% off, 12 bottles annually 6, 15% off, 18 bottles annually 12, 25% off = Wholesale pricing, 36 bottles annually

4, 10% off, 12 bottles annually

6, 15% off, 18 bottles annually

12, 25% off = Wholesale pricing, 36 bottles annually

BILLING ADDRESS *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

SHIPPING ADDRESS *

Tell us your preferred shipping address or select PICKUP as your pref!

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

I will pickup within 2 weeks after release and agree to shipping after that point is up. I will be notified via email at this point.

NOTES: Select preferences: Red only, White only, Pickup preferred.

Winemaker recommendation will always consist of 1 each of the new releases and a mix of seasonal favorites.

Red Wines Only

White Wines Only

Winemaker Recommendation (BEST)

Other (see notes)

In order to receive and retain membership discounts, perks, free admission to wine club events and access to non-public library wines, I agree to receive the minimum of 3 shipments or pickups to receive my membership perks. Early cancellation will result in a $75 fee.

Agree