Membership Cancellation Form
Member Name
*
First Name
Last Name
Email associated with your membership
*
example@example.com
Phone Number
*
Please enter a valid phone number.
What is your current active Wine Club Membership
*
Please Select
Silver Membership (6 bottle shipments)
Gold Membership (12 bottle shipments)
Unknown/Membership not listed
What are the number of shipments you have received since signing up?
*
For cancellations without a fee you will need to have received 3 or more club releases.
What is the reason for submitting a cancellation request?
*
Please Select
Too Much Wine
Financial Reasons
Health Reasons
Pregnant
Moving/Relocating
Switching to another club tier
Other
Please let us know a bit more about your reason for your cancellation request.
*
We are genuinely interested in understanding more about your decision. Your feedback is incredibly valuable to us.
Would you be interested in placing your Membership On Hold?
Please Select
Yes, tell me more
Not at this time
Submit
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