Kindly PRINT this Application for Membership, fill in and mail together with your cheque to the address at the bottom:

Last Name:  
First Name:  
Address:  
City:  
Province:  
Postal Code:  
Home Phone:  
  Business Phone:  
Fax:  
  e-mail:  
 
I hereby apply for membership in the German Wine Society and upon acceptance as a member do hereby agree to absolve and indemnify the Society, its members and executive from any and all liability with respect to any matters arising from my attendance at Society functions; further that I am over nineteen years of age and have not been interdicted from consuming or holding alcoholic beverages.

The German Wine Society is a non-profit organization and reserves the right to refuse a candidate for membership.
Date:  
   
Signature:  
 
Please print and return this application with a cheque payable to:

 German Wine Society
C/o Rose Mary Wald
Unit 30 – 14968 24th Ave.
Surrey, BC
V4A 9Y5