Paumanok Wine 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 $100, $140 or $250 per shipment respectively.

Each shipment will consist of Paumanok 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 Wine Club can be discontinued at any time with no penalty.

As a Wine 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 Wine Club member you will be given priority in reserving for special events and complimentary tastings at Paumanok's Futures Barrel Tasting.

Preferences

Standard membership. No preference.
White wines only.
Red wines only.

I wish to receive four bottles every three months for a charge of no more than $100 per shipment.
I wish to receive six bottles every three months for a charge of no more than $140 per shipment.
I wish to receive twelve bottles every three months for a charge of no more than $250 per shipment.


This Wine 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

Your signature below confirms your enrollment and your
selections above and that you are 21 years of age or older.
An adult signature will be required upon delivery.

Signature: _________________________________________

Please fax us your completed enrollment form at
(631) 722-5110 or mail it to us at:
Paumanok Vineyards
P.O. Box 741
Aquebogue, NY 11931-0741