DEMO – DW – Membership – The Tiddliest

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01

Wine Club Membership

$55 month

Classic

District Wine

02

Club Membership

$75 month

Sophisticate

District Wine

03

Club Membership

$210 quarter

Connoisseur

District Wine

Step 1 of 3

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Wine Club Membership(Required)

Classic - $55 per month (*billed monthly)

Sophisticate - $75 per month (*billed monthly)

Connoisseur - $210 per quarter (*billed quarterly)

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Sophisticate

For Sophisticate members(Required)

Please select your preferred wine choices

One red and one white wine selection

Two red wine selections

Two white wine selections

Name(Required)

First Last

Email(Required)

Phone(Required)

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Second member

Name of second member

First Last

Billing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Shipping Address

Same as billing address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Shipping(Required)

Pick up

Shipping

Total

Payment Method(Required)

Credit Card

PayPal

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Credit Card

Replace this field with a field specific to your payment gateway whenever possible.