To join us please complete the following form including pack selections and submit online. Alternatively print and post to Pizzini Wines Reply Paid 84345 Whitfield VIC 3733 Australia or fax to +61 3 5729 8495.

Required fields are marked *

Personal Details
Title	Select Mr Dr Ms Mrs Miss	*
First Name		* (name on membership card)
Surname		* (name on membership card)
Telephone		*
Mobile
Email Address		*
Username		* (your email address)
Password		* (your preferred password)
Delivery Address
Address		*
Suburb		*
State		*
Postcode		*
If I'm not available please leave my wine at:	Front Door Back Door Reception Other (Please specify)	*
How would you like to receive your newsletter?	Email Post	*
Billing Address  (Click here if the same as your delivery address above)
Billing Address		*
Billing Suburb		*
Billing State		*
Billing Postcode		*
Payment Details
Cheque
Credit Card
Card Type Select Visa MasterCard American Express   Name on Card   CC Number   CC Expiry 01 02 03 04 05 06 07 08 09 10 11 12 / 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022
Delivery Choices
To enjoy the member benefits of Vino e Vita we ask for a commitment to purchase a minimum of two of the delivery choices listed below annually. Please indicate your packs and delivery preferences with a tick in the appropriate box. Pack composition and despatch dates will be detailed in our May & November Tre Amori Newsletters.
Mixed Wine Dozens Per Dozen May Nov Italiana (Mixed Italian Reds & Whites) Average Price $260 Classica (Mixed Reds & Whites) Average Price $230 Rossa (Mixed Red Wines) Average Price $280 Bianca (Mixed White Wines) Average Price $210 Suo Preferito Single Variety Dozens       White Wine       Riesling $167.50 Pinot Grigio $200 Arneis $216 Verduzzo $216 Sauvignon Blanc $173 Sparkling & Rosé Wines       Rosetta (Rosé) $167.50 Il Soffio (Sparkling Rosé) $211 Brachetto $211 Red Wines       Sangiovese Shiraz $167.50 Merlot $194.50 Sangiovese $270 Shiraz $216 Il Barone (6 Pack) $232 / Pack Nebbiolo (6 Pack) $243 / Pack Rubacuori Res Sangiovese (2 Pack) $198 / Pack Coronamento Nebbiolo (2 Pack) $243 / Pack Prices subject to change after 30/6/09.
First Delivery Options
If still available, please send my first delivery straight away.
Please send my first delivery with the next scheduled despatch.
As a Pizzini Vino e Vita Wine Club member I authorise Pizzini Wines to debit my credit card, and any card issued to me in renewal or replacement thereof with the cost of my Wine Club dozens as they occur. I understand my dozens will be delivered automatically unless I advise Pizzini Wines prior to dispatch. I am 18 years or older.
Pizzini Wines Privacy Statement
The information provided by you on this enrolment form will only be used for the purposes for which it is collected. We will not sell, rent, trade or otherwise disclose the personal information you provided to anyone outside of Pizzini Wines. ABN: 65 084 696 249 Liquor Licence No. 32421197 Liquor Act 1982 – It is an offence to sell or supply to or to obtain liquor on behalf of a person under the age of 18 years.
Pizzini Wines 175 King Valley Road Whitfield 3678 Phone +61 (3) 5729 8278 Fax +61 (3) 5729 8495 Email talkdirect@pizzini.com.au