Uvae Wine & Cheese Sign Up
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Member Name *
Phone Number *
Email *
Birthdate *
Is this membership a gift? *
Wine Club Membership Level
Clear selection
Customized allocation (adds $10 - $15)?
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Cheese Club Membership
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Billing Name *
Street Address *
City, State, Zip Code *
Phone Number (if different from member)
Email (if different from member)
Credit Card *
CVC *
Expiration Date *
Submit
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