Wine Club

Membership Application

Membership Purchased:

£   For Myself     £  As a Gift

Membership Type:

£ Price Point Member ~ $65.00 lifetime membership fee                                

£ High Point Member ~ $100.00 lifetime membership fee

Billing Address:                                                                                                      

Name:   ______________________________________

Address:   ____________________________________

City: _______________ State: _____  Zip: __________

Phone:  ______________________________________

Email:  _______________________________________  

Shipping  Address:                                                                                                    

Name:   ______________________________________

Address:   ____________________________________

City: _______________ State: _____  Zip: __________

Phone:  ______________________________________

Email:  _______________________________________  

Wine shipments require a signature of an individual at least 21

years of age at time of delivery.  Please provide a shipping

address where a signature can be obtained during regular

business hours.  The cost of shipments & shipping charges

vary, depending on the wine included.  Currently shipping is

only available in select states.  Please call us to find out if your

state qualifies.

Payment Information:

£ Check ~ Wine shipment information will be mailed or

        emailed one week before the scheduled ship date.

        Payment can be mailed to Windy Point Vineyards.

        Wine can not be shipped until payment is received.

£   Credit Card

£    VISA      £    MASTERCARD

Card Number:   __________________________________

Expiration Date:  _________________________________

I certify that I am 21 years of age or older and give permission to

Windy Point Vineyards to charge my credit card for each shipment

at the time of shipping.

Signature:  _____________________________________

Date of Membership:   ____________________________

Driver's License Number / State:  ____________________

Please print this form and mail back to

Windy Point Vineyards

420 Windy Point Drive

Wapato, WA 98951

If you are uncomfortable sending credit card information through the mail, please send in the form with your signature and

call us with you credit card information. Phone:  (509) 877-6824 or office (509) 877-4446.  Thank you & enjoy!