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Benefits Apply Members Only
FWC / WineAmerica Application

All fields with * are required fields.
Type of membership: Joint Wine Producer 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:  
       (### - ### - ####)
 
Publicly Posted Email:  
Private Email:  
* Note: You consent to allow FWC to market or send emails to you.
*Website:
*Username
*Password
*California
ABC License Number(s)
Type 02
Type 09
Type 17
Type 20
Summary of Organization
(Publicly Posted)

characters left
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 business 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:   
       (### - ### - ####)
Shipping
(Optional)  If you have permits by state, you may check the appropriate state for display on the Buying CA Wine map and enter a permit expiration date.

State Permit expires on:
Check All : Uncheck All
Alaska    
Arizona    
California    
Colorado    
Connecticut    
District of Columbia   
Florida    
Georgia    
Hawaii    
Idaho   
Illinois   
Indiana   
Iowa   
Kansas   
Louisiana   
Maine   
Maryland   
Massachusetts   
Michigan   
Minnesota   
Missouri   
Montana   
Nebraska   
Nevada   
New Hampshire   
New Jersey   
New Mexico   
New York   
North Carolina   
North Dakota   
Ohio   
Oregon   
Rhode Island   
South Carolina   
Tennessee   
Texas   
Vermont   
Virginia   
Washington   
West Virginia   
Wisconsin   
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 Membership Committee
Yes No
 
*Gross receipts last year:
Less than $150,000 $5M to $10M
$150K to $250 K $10M to $20M
$250K to $500K $20M to $50M
$500K to $1 Million $50M to $100M
$1M to $2.5M $100M to $150M
$2.5M to $5M Over $150M
 
*Direct Shipping Match:
  (More Info)
*FWC PAC:  (More Info)
 
Total:  
 
Please note that under Federal Law, 35% of your dues payment for 2014 is not tax deductible as a business expense.





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