Wine Club Questionnaire/Registration Form
CRTA Chapter
Name:__________________________________________________________
Email Address:__________________________________________________
Phone number_____________________________________________
What style of wine do you typically prefer?
Red White Rose' Sparking I like it all!
What regions do you typically purchase from?
USA Australia Canada Italy Other:
What characteristics do you like in a wine?
Fruity Earthiness Big and Bold Medium body Sweet
What grape varietal do you typically enjoy?
Cabernet Sauvignon Pinot Noir Malbec Syrah/Shiraz Merlot
Chardonnay Sauvignon Blanc Riesling Pinot Gris Blends
Name 3 wines that you love and consider memorable:
If you drink coffee, how do you typically drink it?
Black Cream and Sugar Sugar Cream Specialty
_______________________________________________________________________
$50 Registration paid by Visa MC AMEX Debit Cheque
(Registration fee includes two exclusive bottles delivered with your first offering).
I'm registering in the following Quarterly Offering (Circle One): $100 $150 $200