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Domaine Serene Direct Shipment Club Membership Application

In addition to current release wines, Domaine Serene wine club shipments will often include winery-only wines, single-vineyard wines, and special wines created specifically for club members. Your membership is recurring. Simply sign-up, provide your shipping address and payment info rmation, and we'll do the rest. Enrollment is first come, first serve so don't delay! Simply complete this online form and a winery representative will contact you with details regarding your first shipment. You may also download a printer friendly copy of the form HERE. Costs will vary based on items included. Subscriptions can also be given as gifts. Please select the club you are interested in:
The Fleur de Lis Club is limited to 300 members who will receive one case per year of Domaine Serene and Rockblock wines; six bottles in the fall and six bottles in the spring.
The Gold Eagle Club is limited to 100 members who will receive four cases per year of Domaine Serene and Rockblock wines; 2 cases in the fall and 2 cases in the spring.
The Rockblock Rockstar Club is limited to 300 members who will receive one case per year of Rockblock wines only; six bottles in the fall and six bottles in the spring.
Is this a gift membership?
YES NO

Gift card should read:

BILLING INFORMATION
As a Domaine Serene Direct Shipment Club Member, you will receive two shipments per year in the fall and in the spring of Domaine Serene wines. Wines are subject to change due to availability. The Club will bill your credit card plus sales tax where applicable for each regular selection. Your credit card will also be billed for shipping and handling. Applicable shipping charges are available by calling a winery representative. Enrollment in a Domaine Serene Direct Shipment Club is a one year commitment (2 shipments) and will automatically renew each subsequent year. Cancellation must be received in writing at least three weeks prior to a scheduled shipment date. It is your obligation to notify Domaine Serene of any address changes before wines are shipped. Domaine Serene will not be responsible for shipping charges incurred due to misdirected wines.

You may also download a printer friendly copy of this form HERE

Simply complete the printed form and fax to 503-864-4500

Name
Address
City
State Zip
E-mail
Daytime Phone
Evening Phone
Domaine Serene will hold your selections for 30 Days, after which they will be shipped. All selections that are shipped are subject to shipping charges.
Will Call? YES NO
SHIPPING ADDRESS/GIFT RECIPIENT
Business address preferred, adult signature required for delivery; wine cannot be shipped to a PO Box
Name
Business
Residential
Company
Address
City
State
Zip
E-mail
Daytime Phone
Evening Phone
CREDIT CARD INFORMATION
Card Type
Card Number
Expiration of
I certify that I am 21 years or older

 

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6555 N.E. Hilltop Lane, Dayton, OR 97114 - Phone: 1-503-864-4600
Toll Free: 1-866-864-6555 - Fax: 1-503-864-4500 - E-Mail: WineClub@domaineserene.com