WINE CLUB MEMBERSHP

THANK YOU FOR YOUR INTEREST IN THE URBAN CONNOISSEURS WINE CLUB
PLEASE COMPLETE THE INFORMATION BELOW TO SIGN UP

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Name *

First

Last

Address *

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City

State

Zip Code

Country

Phone Number *

Email *

Please select your Membership *

VIP Member - Annual $750 (4 bottles, includes tax and shipping) Urban Connoisseurs Membership $150/qtr - 4 bottles Urban Connoisseurs Membership $89/qtr - 2 bottles

What is your wine type preference? *

All Red Wines (May include Rosé or Sparkling Rosé) All White Wines (May include Sparkling) Mix - 2 Red and 2 White wines Mix - 1 Red and 1 Wine wine

Referred by: *

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WINE CLUB TERMS AND CONDITIONS

URBAN CONNOISSEURS WINE CLUB MEMBERSHIP

THANK YOU FOR YOUR INTEREST IN THE URBAN CONNOISSEURS WINE CLUB
PLEASE COMPLETE THE INFORMATION BELOW TO SIGN UP

Telephone

Email

URBAN CONNOISSEURS WINE CLUB MEMBERSHIP

THANK YOU FOR YOUR INTEREST IN THE URBAN CONNOISSEURS WINE CLUB​PLEASE COMPLETE THE INFORMATION BELOW TO SIGN UP​

Telephone

Email

THANK YOU FOR YOUR INTEREST IN THE URBAN CONNOISSEURS WINE CLUB
PLEASE COMPLETE THE INFORMATION BELOW TO SIGN UP