*First Name

*Last Name

*Billing Address (Line 1)

Billing Address (Line 2)

*City

*State

*Zip Code

*Email Address

*Phone Number (no dashes, periods or spaces between numbers, please)

*Date of Birth (Required for Legal Compliance) Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029

*How would you like to receive your Allocation? Please Ship it to me
I'd like to pick it up at the Winery (OR & WA Residents Only)

*Name on Credit Card

*Credit Card Number

*Expiration Month 1-Jan 2-Feb 3-March 4-April 5-May 6-June 7-July 8-Aug 9-Sept 10-Oct 11-Nov 12-Dec

Expiration Year 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035

*CVV/Security Code

If your Shipping Address is different from your Billing Address please include your shipping address here. We highly suggest using a shipping address where someone is around during the day like an office or UPS Store facility to ensure your wine is delivered as a 21+ Signature is required for delivery.

*Which member of the Lingua Franca Team hosted you today? George Mc Manus
Jon Cabe
Kristen Page
I joined at an Event
I joined on the Website

*What methods are best to communicate with you? Email
Phone Call
Text Message

*Do you give us permission to text you with relevant information about your club like important dates and tracking information? Yes No

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