Anderson Wine Club

Please fill out the following form to join our club. There are two levels of membership:

$25 basic membership

$50 executive membership

(we can accept only checks or cash for membership dues, which you can leave in any of our boxes at the Anderson School. If you are leaving cash, please indicate that it is for Wine Club membership. Make checks out to the Anderson Wine Club.)

An asterix (*) indicates a required field.

* First Name:		* Last Name:
* Email Address:
	* Type of Membership:	Basic	Executive
	Please check this box if you would also like a membership for a spouse / significant other. (both memberships will be the same type)
Class of:	2000	2001	Faculty / Staff
Interests:	Tastings	Dinners	Trips
	by Varietal	Region