Wine Club Application

Yes, I want to become a member of Sausal Winery's wine club! Once a member, I understand I will regularly receive Sausal wine 4 times per year(ZinFanz) or 12 bottles two times per year(ZinMasterz), until I cancel my membership. Membership is limited to shipping addresses in the following states and you must be 21 years old or older to join:

Check Here for ZinFanz Club Select shipment quantities 2 4 6
ZinMasterz Club (SORRY FULL CALL FOR WAITING LIST)

Membership is limited to shipping addresses in the following states and you must be 21 years of age or older: 
CA, CO, FL, HI, ID, IL, IA, MN, MO, NC, (*ND), NH, NM, NV, NY, OH, OR, TX, VA, WA, WI, WV, WY
(*Not Eligible for ZinMasterz)


Name (first and last): _____________________________________________________

 Referred By:____________________________________________________________

Business:_______________________________________________________________

Shipping Address:________________________________________________________
(Address normally occupied during weekdays; e.g., Business; No PO Box, adult signature required)
Please note; If more than one attempt to ship is required, you will be charged to reship.

Shipping City/State/Zip: ___________________________________________________

Business Phone: _________________________________________________________  

Billing Name (if different from member name):____________________________________

Billing Address: __________________________________________________________
(If different than Shipping Address newsletters and invoices sent here.)

Billing City/State/Zip:______________________________________________________  

Phone:_________________________________________________________________

Credit Card Account Number (Visa/MC only): __________________________________  

Credit Card Expiration Date:    ___ /___

E-mail Address:________________________________________________________________
(Preferred for notification of shipment arrival)

Cardholder Signature:_________________________________________ Date:  _____________    

Please provide date of birth & drivers license #:________________________________________
(Membership limited to those at least 21 yrs. of age)
 I will pick up my wine at the winery.
  (Limited to CA residents. Pickup required within 30 days. Shipping Address required.)

Please Send or Fax This Completed Membership Application Form To:
Sausal Winery 7370 Highway 128 Healdsburg, CA  95448 FAX: (707) 433-5136