Passport: Legacy VIP Application for 2018

Question Title

* 1. First & Last Name of Purchaser:

Question Title

* 2. Email:

Question Title

* 3. Phone Number:

Question Title

* 4. Mailing Address:

Street Address:

City

State

ZIP

In order to qualify for Legacy VIP status in 2018 you needed to have made a total of $300 in wine purchases during the 2017 Passport Wine Event. This can be a single purchase at one winery or several purchases at multiple wineries totaling $300. Please fill out the form below with your qualifying sales receipt(s) information.

Question Title

* 5. Winery #1:

Winery Name:

Total Amount Spent:

Transaction Number (on receipt):

Question Title

* 6. Winery #2: (if applicable)

Winery Name:

Total Amount Spent:

Transaction Number (on receipt):

Question Title

* 7. Winery #3: (if applicable)

Winery Name:

Total Amount Spent:

Transaction Number (on receipt):

Question Title

* 8. Winery #4: (if applicable)

Winery Name:

Total Amount Spent:

Transaction Number (on receipt):

Question Title

* 9. Winery #5: (if applicable)

Winery Name:

Total Amount Spent:

Transaction Number (on receipt):

Question Title

* 10. Please upload a picture of your receipts.

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.

Need help? Give us a call at (916) 862-0956

You will be notified of your acceptance into the Legacy VIP program by August 2017. If you do not hear from us by then, please email info@eldoradowines.org.