Main Street Wine & Beer
Thank you for your interest in our New Wine Club. Please answer the following questions to help us customize your experience. 
After you complete this form an invoice will be sent to you for the selected subscription option. Once the invoice is paid, you are welcome to stop by the store to pick up your monthly selection of wine. 
Invoice will be automatically sent to you on the 1st day of every month. You will have a option of saving your payment information to automate the process and simply enjoy your fresh monthly selection of wines. 
Please let us know if you have any questions, we are always happy to help! 
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Full Name *
Email Address *
Phone Number (this will also be your member number to receive 5% discount on all retail purchases) *
Which Membership Option are you interested in? *
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