JOIN THE WINE CLUB

To join Raffles Liquor Merchants as a Wine Club Member,complete the requested information below. At all times your personal information will be maintained securely.

By joining the Raffles Liquor Merchant Wine Club you will be able to save significantly on premium wines and you will also be able to enjoy 15% of wine at the Cocos and Deco Restuarants

Wine Club Membership Price: $115.00

Step 1: Personal Details E-mail

(to be used as your Login Name)

Password

(4 to 8 characters long)

Confirm Password

Please re-type the password

NOTE: We recommend not using same password you use for high-security sites like your bank accounts, etc.

Salutation

First Name

Last Name

Step 2: Address Details Company Name

Job Title

(If Applicable)

Address

Suburb/City

State

Post Code

Country

Phone

(Including area code)

Fax

(Including area code)

Step 3: Choose your Payment Method

Tax Invoice
Raffles Liquor Merchants, ABN 82 807 996 950

Total AUD (incl. GST)

$115.00

I wish to pay by
Credit Card

Credit Card

Card Type: VISA MASTER AMEX DINERS

Cardholder's Name: Card Number: for example: 1111222233334444 (no spaces or hyphens required) Expiry Date:

What's this? Card CVV:

Direct Deposit

Name: Raffles Liquor Merchants
Bank:
BSB:
Account: