Benefits Apply Members Only
Family Winemakers Application

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Type of membership: Winery or Vineyard

Organization Profile
*Name of Organization:


Salutation:
*First Name:
Middle Name:
*Last Name:
Winery or vineyard physical address
*Street: *City:  
*State: *Zip:  
*Phone: Fax:  
       (1- ### - ### - ####)
May we send faxes after 6pm?
Yes No
Publicly Posted Email:  
Private Email:  
Website:
*Newsletter Style
Text Email Email with PDF Fax Mail
*Username
*Password
*California
ABC License Number(s)
Type 02
Type 09
Type 17
Type 20
Summary of Organization
(Publicly Posted)

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California Senator
California Senate District
California Assembly Member
California Assembly District


Administration Profile
If you prefer your FWC information sent to a location other than your winery or vineyard address please change the information below.

Click on the button to clear your Administration Profile or copy your Organization Profile.
  

Salutation:
*First Name:
Middle Name:
*Last Name:
*Street: *City:   
*State: *Zip:   
*Phone: Fax:   
       (1 - ### - ### - ####)
Shipping
(Optional)  If you have permits by state, you may check
the appropriate state and enter a permit expiration date.

State Permit expires on:
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Washington   
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Wyoming   


Membership Information
Issues of Concern
*I am interested in serving on the Legislative Committee
Yes No
*I am interested in serving on the Tasting Planning Committee
Yes No
*I am interested in serving on the Technical Committee
Yes No
 
*Number of cases sold last year:
My case production is 5,000 or less -- (min. $225)
My case production is greater than 5,000
*Direct Shipping Match:  (More Info)
*FWC PAC:  (More Info)
 
Please note that under Federal Law, 35% of your dues payment for 2008 is not tax deductible as a business expense.
Total Dues:   





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