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Wine Club
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Member Information:

Please fill in your name and address as they appear on your credit card statement.

First Name:

Last Name:

Address:

City:

   State:   Zip Code:

Home Phone:

Work Phone:

Email:

Birthdate:

Wine Club Login Account:

Providing a username and password will allow you to enjoy Member benefits while visiting our online store.

Username:

Password:

Card Information:

Name:

Type of Card:

Card #:

EX: 0001231234245 no spaces

Expiration Date:

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Terms:

Please enroll me as a Duet Member.

Please enroll me as a Quartet Member.

I certify that I am 21 years of age and I give my permission to Indian Springs Vineyards to charge my credit card for each shipment at the time of shipping. I understand that I can cancel my membership at any time after the first shipment.

I prefer to pick up my wine, please send me a postcard when my selections are ready.

I have read and agreed to Indian Springs Vineyards > Shipping Policy

 

Nevada City Wine Tasting
Wine Tasting Room (800) 375-9311 or (530) 478-1068  |  Wine Vineyard Office (530) 478-5790
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