Cuda Cadre Wine Club Application
To join the Cuda Cadre wine club, print out this page = and email it (info@cudaridgewines.com)= , FAX it (925-292-0192), or bring to the winery
BILLING INFORMATION
Name: &n=
bsp; =
; &n=
bsp; =
; &n=
bsp; &=
nbsp; &nbs=
p;
Mailing Address: &n= bsp; = ; &n= bsp; = ; &n= bsp; = ;
City: &n= bsp; = ; &n= bsp; = ; &n= bsp; = ; &n= bsp;
State: &n=
bsp; =
; Zip: &n=
bsp; =
; <=
/span>
Home Phone: &n=
bsp; =
; &n=
bsp; =
; &n=
bsp;
Cell Phone: &n=
bsp; =
; &n=
bsp; =
; &n=
bsp; =
; &n=
bsp;
Email Address: _________________________________________
CREDIT CARD INFORMATION
Credit Card (Circle one): Master Card/Visa/Discover/American Express
Credit Card Number:&n= bsp; |__|__|__|__|-|__|__|__|__|-|__|__|__|__|-|__|__|__|__|__|
Expiration Date (mo/yr): ____/____
____ I will pick up wine at Cuda Ridge W= ines tasting room (any wine not picked up in 30 days will be shipped and charged= to credit card)
_____ Please ship my wine to mailing address (note: Adult Signature Required for delivery)
SHIPPING ADDRESS (if different from above):
Shipping Address: &n=
bsp; =
; &n=
bsp; =
; &n=
bsp; =
;
City: &n=
bsp; =
; &n=
bsp; =
; &n=
bsp; =
; &n=
bsp;
State: &n=
bsp; =
; Zip:
&nb=
sp; =
&nb=
sp;
I certify that I am 21 years or older. I understand th= at adult signature is required upon delivery of wine when shipped. I understand that my credit card w= ill be billed at wine release (twice per year), including shipping charges if applicable. I understand that= I can cancel the wine club anytime after receiving my first shipment, upon written notice to the winery.
Signature: &n=
bsp; =
; &n=
bsp; =
; &n=
bsp; =
; Date: &n=
bsp;
Cuda=
Ridge
Wines
www.CudaRidgeWines.com 510-304-0914
Mailing Address:
=