Pooley Wine Club Membership Form

Use the form below to join the Pooley Wine Club online.

When your application is received, we will contact you to confirm details and arrange payment.

Alternatively, you may prefer to print our Wine Club Membership Form and fax it to us on (03) 6260-2895.

(* indicates required fields)

Your contact details:

Name:*

Date of birth:

Daytime phone:*

Mobile:

Email:*

Delivery address:

Delivery Address:*

Town/Suburb:

Postcode:*

Ignore this text box. It is used to detect spammers. If you enter anything into this text box, your message will not be sent.

Your wine selection:

(Choose one of the following two options)

I would like a Wine Makers Selection sent in May, August and November for $169.00

I would like to design my own Cellar Pack to be sent in May, August and November for 15% off Cellar Door prices. My wine selection is as follows:

Wine 1:

Wine 2:

Wine 3:

Wine 4:

Wine 5:

Wine 6:

Additional delivery instructions/comments

In placing this order, I am confirming that I am over 18 years of age, and that I have read and agree to the Pooley Wine Club Terms and Conditions.

Pooley Wine Club Membership Form

Associated links:

Phone/Fax: 03 6260 2895 (Intl: +61 3 6260 2895)

Mobile: 0408 652 296 (Matthew Pooley)