Club Online Registration

WINE PROGRAMS

Please select the program of your choice

Village

3 Bottles	*3 month $186*	*6 month $372*	*12 month $744*
6 Bottles	*3 month $360*	*6 month $720*	*12 month $1440*

Premier-Cru

3 Bottles	*3 month $276*	*6 month $552*	*12 month $1104*
6 Bottles	*3 month $540*	*6 month $1080*	*12 month $2160*

Grand-Cru

3 Bottles	*3 month $366*	*6 month $732*	*12 month $1464*
6 Bottles	*3 month $720*	*6 month $1440*	*12 month $2880*

All final applications must be made in person at i.m.Wine.

BILL TO ADDRESS

Name

Address

City, State, Zip

E-mail address

Contact phone number

PAYMENT OPTION

Month to Month

Prepaid

We accept all major credit cards and corporate checks. Initial order must be placed in person at i.m.Wine.
We will contact you for payment information.

8180 Maple Lawn Boulevard, Fulton, Maryland 20759
Phone: 240.456.0330, Fax: 240.456.0333
Hours: Monday thru Saturday 10:30-7:30