Qty	Item	Description	Price	Total
	Subtotal	$0.00

My Way Wine Club

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Wine Selection

Enjoy your June wine selections!

Billing Information

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*First Name

*Last Name

Company

*Address

*City

*Province

*Postal Code

*Phone

*Email

Club Notes

Shipping Information

Username/Password

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*Username

*Password

*Confirm Password

Payment Method

Secure Shopping
The security of your sensitive information is important to us. When you enter sensitive information such as a credit card number on our order forms, we encrypt that information using secure socket layer technology.

Enter your billing information as shown on your credit card statement.

*Credit Card:

*Name On Card:

*Credit Card Number:

*Expiration Date:

Your order is safe and secure