Texoma Winery - Wine Club

---I want to give a Texas Tasting Wine Club Membership---

---What we need to know about the giver...

Name:

Telephone:

Email:

Billing Address:

Credit Card Type:

Credit Card Numer:

CVC Numer:

Expiration Date:

---Select Your Gift Trial Membership Term---
Call or e‐mail to arrange special gift memberships or to include Texas Double Down Specials. Price includes shipping and handling.

Membership Type:

---What we need to know about the recipient...

Name:
Telephone:
Email:
Shipping Address:	123 Your Street Your City, State 12345