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  Paumanok Grand Vintage Club
Enrollment Form
YOU MUST BE 21 OR OLDER TO ENROLL.

In completing this form, you agree to have four, six or twelve bottles of Paumanok wines shipped to you, every three months for a charge not to exceed $140, $200 or $375 per shipment respectively.

Each shipment will consist of Paumanok Grand Vintage and/or Late Harvest wines that are new releases, current releases or from past vintages. The cost per shipment shown above includes tax and shipping for delivery in New York State (there is a surcharge for out of state shipments). Membership in the Paumanok Grand Vintage Club can be discontinued at any time with no penalty.

As a Grand Vintage Club member, you will be entitled to receive discounts on purchases at the winery or phone/internet orders. Discounts are 10% on 3 to 5 bottles, 15% on 6 to 11 bottles, 20% on a case or more. As a Grand Vintage Club member you will be given priority in reserving for special events and complimentary tastings at Paumanok's Futures Barrel Tasting.

If you prefer not to complete an online enrollment form, click on the link below for a printer friendly version, and fax it to us at (631) 722-5110 or mail it to us at: Paumanok Vineyards
P.O. Box 741
Aquebogue, NY 11931-0741


Standard membership. No preference.
Grand Vintage red wines only.
Late Harvest dessert wines only.


I wish to receive four bottles every three months for a charge of no more than $140 per shipment.
I wish to receive six bottles every three months for a charge of no more than $200 per shipment.
I wish to receive twelve bottles every three months for a charge of no more than $375 per shipment.


This Grand Vintage Club membership will be in this person's name.
Member Name


Billing Information
First Name
Last Name
Address
City
State
Zip Code
Is this a residential address?
Home Phone
Work Phone
Email Address
Credit Card
Credit Card Number
Expiration Date
Shipping Information
Shipping info same as billing?
First Name
Last Name
Address
City
State
Zip Code
Is this a residential address?
Ship Phone

By clicking on the button below you are making an electronic
signature that confirms your enrollment and your
selections above and your age of 21 or older.
An adult signature will be required upon delivery.