Membership Checkout

A Payment Gateway must be set up before any payments will be processed.

Membership Level

You have selected the Annual Membership Level membership level.

Confirm your annual membership to secure your mixed case of wine! This membership gets you access to sine not found in Mississippi!

The price for membership is $261.50 per Year. Customers in MS will be charged 7% tax.

Username

Password

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First Name

Last Name

Email Address

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Full Name LEAVE THIS BLANK

Liquor Store Requested

Which liquor store would you like your order shipped to? Delivery ability based on your personal relationship with the liquor store you have chosen.

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First Name

Last Name

Address 1

Address 2

City

State

Postal Code

Country

Phone

Ship to the billing address used above.

First Name *

Last Name *

Address 1 *

Address 2

City *

State *

Postal Code *

Phone *

Country *

Card Number

Expiration Date /

Security Code (CVC)

A Payment Gateway must be set up before any payments will be processed.

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