Membership Application Form
Name (*)
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Address
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State
NSW
VIC
SA
WA
QLD
TAS
ACT
NT
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Postcode
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Phone Home (*)
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Phone Mobile
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Email (*)
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Type of Membership (*)
GREY
RED
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I would like to recieve a mixed dozen every (*)
3 Months
4 Months
6 Momths
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Wines are subject to availability. Payment will be debited from your account immediately after the wine has been dispatched.
One of our club representatives will be in contact with you shortly to complete your membership. welcome to the Kangaroo Island Estate wine club
