WINE CLUB MEMBERSHIP SIGN UP FORM

Join Cesar Toxqui Cellars Wine Club and you will received four shipments a year. One in March, June, September and December. We have two levels of Wine Club Membership. They are as follows.

1)- Tour of Mendocino (25% off )
By selecting this option you will receive 6 bottles of our fine wine selections of your choice four times a year. It could be a combination of red and white wines. We can ship it to you or you can pick it up at our tasting room. Shipment dates are March, June, September and December. However you are welcome to decide a better date for yourself.

2)- Peloton Level (15% off )
By selecting this option you will receive 3 bottles of our fine wine four times a year. We can ship it to you or you can pick it up at our tasting room. Shipment or pick up dates are March, June, September and December. However we welcome other dates of your choice.

Cesar Toxqui Cellars, Ruthless Red ,Hugh Oliver Sparkling Wine PalomaBellaDulce port style wines.

Please Select One :
Tour of Mendocino (25% off )
Peloton Level (15% off )

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[Member Information]
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First Name*

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[Shipping Information]
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Please Select One :
My Shipping Address is same as Member Address
Please use the Address given Below
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First Name*

Last Name*

Street Address*

City*

State*
Please SelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming--District of ColumbiaPuerto RicoGuamAmerican SamoaU.S. Virgin IslandsNorthern Mariana Islands
Zip Code*

Telephone*

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[Payment/Credit Card Information]
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First Name* (Exactly as it appears on your Card)

Last Name* (Exactly as it appears on your Card)

Credit Card Number*

Credit Card Expiration* (MM/YY):
▼010203040506070809101112 / ▼1819202122232425262728
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Any Message or Special Instructions

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Review and Complete this Sign-up !!!
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By Clicking SUBMIT button below, I authorized Cesar Toxqui Cellars to charge my credit card for wine and shipping charges. Also I agree to be Wine Club member for at least one year.

By placing an order for an alcoholic beverage through our website, you formally represent that you are at least 21 years of age and that the intended recipient of the shipment is at least 21 years of age.

Today's Date :

Email: sales@toxqui.com/ctcellars@sbcglobal.net
Tel: (7O7) 391-8412 Sales