To join First Choice print out this form, fill it out, sign it, and FAX it, mail it or
bring it to Bent Creek Winery, 5455 Greenville Road, Livermore CA. 94550. FAX (925) 449 4134
Name of Member _____________________________________________________
Mailing Address ______________________________________________________
City __________________________________ State _______ Zip ______________
Home Phone (____)_______________ Work Phone(_____)____________________
E-mail______________________________________________________________
Master Card / Visa (circle one) Credit Card Number __
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|__|__|__|__| - |__|__|__|__| - |__|__|__|__| - |__|__|__|__| Exp. Date _____ _______
First Call Options - Circle your wine choice Reds Only White Only White and Red
_____ I will pick up my wine at the Bent Creek Tasting Room.
(Any wine not picked up within 30 days of the sale date will be automatically shipped and
charged to club member)
>_____ Please ship my wine to my mailing address.
(Business address may be preferred because an adult signature is required for delivery.)
Shipping Address ( if different from above )__________________________________
Street: _____________________________________________________________
City: ____________________________________ State _______ Zip ___________
I certify that I am 21 years or older. I understand that upon delivery, an adult signature is required
and that my packages will not be left at my door. I understand that I am responsible for all costs
incurred as a result of my wine shipment being returned to the winery and for reshipment.
I understand that my credit card will be charged quarterly for my wine (and shipping costs if applicable).
I understand that I may cancel my First Call membership with a written 30-day
notice prior to the quarterly shipment of wine.
All information supplied on this application is held in strict confidence. We do not sell
or give mailing information.