Print this form, and fax or post to the address below
PO Box 41463, St Lukes
Auckland 1346, New Zealand
USA Fax Number: (815) 366-8145 | UK Fax Number: 0870 762 6915
feedback@wine-searcher.com
Sponsorship Payment
|
|
Print this form, and fax or post to the address below |
|
PO Box 41463, St Lukes |
Auckland 1346, New Zealand |
USA Fax Number: (815) 366-8145 | UK Fax Number: 0870 762 6915 |
feedback@wine-searcher.com |
|
Sponsorship Payment |
|
Select a sponsorship period (tick one option below):
12 months (USD 3500)
Six months (USD 1900)
Three months (USD 1000)
Monthly (USD 370)
Please charge my:
Mastercard Visa
|
Card Number: |
|
|
Business Name: _____________________________________________ Cardholder Name: ___________________________________________ Expiry Date: ____ / ____ Signature: _______________________________________________ Today's Date: _______________ Phone No.: __________________ Your Email Address: ____________________________________________ |
Please Note: If the monthly subscription option is selected, your card will be debited once each calendar month until you notify Wine-Searcher otherwise. We will confirm the date of cancellation by email within 2 working days.
