Bluestone Vineyard Wine Club

Member Benefits:  3 great Bluestone Vineyard wines every quarter!!  Access to limited release and library wines!!  Advance tastings of coming releases!!  A pair of tokens valid for any Toast the Weekend event every quarter!!  10% discount on all wine purchases!! (15% after your first year)  Free tastings for members!! Press Club  Invitations to Members-Only Events!!

Applicant Information [ ] I’d prefer to pick up my wines at the ______tasting room Applicant Name(s) [ ] Please ship my wines to me (additional ______shipping cost will be applied, please see Address shipping requirements on back of form)

______[ ] My shipping address is the same as my City, State, Zip code billing (if not, see back of form)

______Phone Number [ ] Winemaker’s Choice ($50-65)

______[ ] Sweet Selections ($45-60) Email [ ] Only Reds ($60-75)

Payment Information Billing Address (if different from above)

______Name on Card Address

______Card Number City, State, Zip code

______Expiration Date (month/year) Phone Number

______Email I agree to purchase three wines quarterly. Bluestone Vineyard will charge my credit card for wines and shipping charges (if I decide to have them shipped) on the 5th of March, June, September, and December. Wines may only be shipped to certain states, please ask upon sign up.

______Cardholder Signature Date Shipping Requirements  Must have someone 21 years of age or older to sign for delivery  We can only ship UPS and shipping rates are charged according to destination  Due to regulations, we can only ship to the following states (please select one):

[ ] Arizona (2 cases maximum per year) [ ] North Carolina [ ] California [ ] Pennsylvania (must ship to PA Wine & [ ] Florida Spirit Store*) [ ] Georgia [ ] Rhode Island [ ] Minnesota (2 cases maximum per year) [ ] Virginia [ ] Missouri [ ] Washington DC (1 case maximum per [ ] New York month)

*PA adds taxes so an amount cannot be quoted until the invoice is filled out

Shipping Address (if different from front)

______Name

______Address

______City, State, Zip code

Please leave blank (Bluestone Use Only)

______Date signed up

______Bluestone employee responsible for sign-up

______Email entered into constant contact

______Application entered into Wine Direct

______Thank-you card written and sent