Join Senders Wine Club

 

Member Information
Check One: Pick Up Please Ship
Name:
Email:
Phone:
Street Address 1:
Street Address 2:
City:
State:
Zip:
Birthdate: ,
Ship to: Business Residence
Note: Federal law requires that wine shipments to a residence be signed for by an adult or be sent to a business address.
 

Gift Information

(Fill out only if sending Club Membership as a gift)
Gift Recipient:
How Long?: 1 Year Ongoing
Email:
Phone:
Street Address 1:
Street Address 2:
City:
State:
Zip:
Birthdate: ,
 

Club Type

Choose one: Imperium Club Magnum Club
 

Credit Card Information

Card Type:
Name on Card:
Card Number:
Expiration Date:
Comments
 

By agreeing to become a member of the Senders Wine Club, I am at least 21 years of age and my credit card will be billed up to 4 times per year just prior to receiving my bottles; Wine Club cancellations must be made by phone and after receipt of two shipments

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