Winemaker's registration form

Name

First NameLast Name

Domain name

Role in the domaine

Email address

example@example.com

Tel number (with country code)

Please enter a valid phone number.Format: (000) 000-0000.

Country

Wine Region(s)

What appellations do you work with?

What certifications do you hold?

Other certification (please specify)

Website

Do you have an Instagram account?

Instagram account full address

How many years have you been in operation?

Total Vineyard Area (in hectares)

What is your average annual wine production volume (in 75cl bottles)?

How does your operation impact the environment? Please describe the practices you use and their environmental effects.

(Agroforestry, bird sanctuary, bees, planting hedges, etc)

Why would you like to sell with our cooperative? What about our cooperative resonates with you? Please explain.

Are you interested in working with us in:

Other interest (please specify)

Legal company name

Registered head-office address

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

Company registration number

Intra-EU VAT number

EORI number

France : l'immatriculation EORI se fait uniquement au niveau du siège social (FR + SIREN). Démarche gratuite : https://www.douane.gouv.fr/demarche/enregistrer-votre-entreprise-aupres-de-la-douane-numero-eori

Are your bottles shipped under CRD capsules (excise duty already paid)?

Would you like to become a coop member?

(it is not compulsory to become a member to sell on vivan.coop)

Do you have another other questions or remarks?

I accept Vivan terms and conditions of sale (https://vivan.coop/pages/winemaker-seller-terms)

Submitted

MonthDayYear

Hour MinutesAM/PM Option

Winemaker's registration form

Customs & legal details (required to ship to the UK)