:: Please fill in the following information to join our wine club:

Wine Club Benefits:

. Four shipments per year (March, June, September, December)
. Four bottles per shipment or six bottles per shipment
. 25% OFF Wine Club orders
. Discounts on ALL purchases
. Admission to special events and release parties

Name:

Check One:    Pick Up      Ship Wine to Me

Daytime Address: (Must be someone over 21 available to sign for package)

City:
State: -- AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NJ NH NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip Code:

E-mail Address:

Daytime Phone:   Evening Phone:

Credit Card #: Card Type: Visa  MC   AMEX
Expiration Date:  Credit Card Security Code:

Credit Card Billing Address (including zip code):

City:
State: -- AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NJ NH NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip Code:

Please be sure to give us a daytime shipping address. UPS requires an adult signature
for delivery of wine. If your package is returned because UPS is unable to deliver, we
will hold your shipment for 30 days while we attempt to contact you. If we are able to,
we will re-ship and charge you only the shipping cost for the second attempt.

Please contact us at 209.728.9817 if you have any questions about the club.
If you would like to use a printable form that can be faxed, please click here.

 

Thank you for your interest in Newsome-Harlow Wines!