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Join Melrose Club

 

Member Information

Check One: Pick up at Vineyard Ship
Name:
Email:
Phone:
Street Address 1:
Street Address 2:
City:
State:
Zip:
Check One or More: Business Home Gift
Note:Federal law requires that wine shipments to a residence be signed for by an adult or be sent to a business address.


 

Gift Information

(Fill out only if sending Club Membership as a gift)
Gift Recipient:
How Long?:
Email:
Phone:
Street Address 1:
Street Address 2:
City:
State:
Zip:


 

Credit Card Information

Card Type:
Name on Card:
Card Number:
Expiration Date: ,
Date of Birth: ,


Comments
 

By agreeing to become a member of the 'Melrose Club', I am at least 21 years of age and my credit card will be billed 4 times per year just prior to receiving my seasonal bottles; each billing not to exceed $55.00 to $65.00 PLUS SHIPPING for quarterly deliveries. I can cancel my membership at any time with 30 Day Written Notice after my first 2 shipments.

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Club Calendar | Benefits

 

A Southern Oregon Tradition Since 1996

541.672.6080; 885 Melqua Road; Roseburg, OR 97470