Wine Club - Mt Cathedral Vineyards

Wine Club Sign Up

*note: you need to be at least 18 years of age to join the wine club

SHIPPING INFORMATION (* indicates required fields)
Title: Mr. Mrs. Ms. Other
*First Name:		Business Name:
*Last Name:

*Address:		*Suburb:

		State: Postcode:

*Email:
We will use your email address to contact you when your wine club selection has been shipped. We will also notify you of special members' only offers from Mount Cathedral Vineyards wine club. How would you prefer us to talk to you in the future? Please select one or more from below: email postal email AND postal mail
You may unsubscribe from our service at any time by sending an email to mtcathedralwine@optusnet.com.au.

*Phone:


CREDIT CARD INFORMATION

*Card Type:

*CC #:

*Exp. Date:	/	*Date of Birth: / / 19

Card Certification Number: (final 3 numbers on back for Visa, Mastercard and Discover. For American Express, front of the card, locate the final 4 digit number above card number)*




BILLING ADDRESS: (if different from above)

First Name:

Last Name:

Address:		Suburb:

		State: Postcode:

* I understand I will receive four (4) 2-bottle shipments per year and my credit card will be charged $40-$60 per shipment. Mount Cathedral Vineyards Wine Club Policy: I certify that I am18 years of age or older. I authorize Mount Cathedral Vineyards to charge my credit card for each shipment. I may cancel my membership at any time. I understand that I am to notify Mount Cathedral Vineyards of changes to my billing/shipping address. Extra shipping charges resulting from incorrect address information are my responsibility. Shipments cannot be made to PO boxes. * I have read and agree to Mount Cathedral Vineyards Wine Club Policy




GIFT MEMBERSHIP (Recipient must be 18 years or older)

Please complete the following to give a membership as a gift to friends, relatives or associates. Wine cannot be delivered to a PO Box.

Name:

Address:		Suburb:

		*State: Postcode:

Daytime Phone: (required)


	Duration:	3 Months 6 Months 9 Months 1 Year Other


	Gift Card should read: