| Company Name |
|
| Address |
|
| Town |
|
Post Code/Zip Code
|
|
| Region/County/State
|
|
Country |
|
| Registered tax number or
V.A.T. number |
|
Telephone Number |
|
| Fax Number |
|
Email Address |
|
| Web Site Address |
|
| Company Founded |
|
No. of Employees |
|
| Services Provided / Nature of Business |
|
| Please attach a brief
outline of your activities, the contribution you expect to bring to the IWCA
and the business benefits you expect to obtain from it. |
| Application: We hereby
apply for Correspondent Status of the INTERNATIONAL WINE CLUBS ASSOCIATION and,
if successful, accept our responsibilities under the terms of its Bye Laws and
within the spirit of its Code Of Conduct. |
| Signed: |
|
Dated: |
|
Print out this form and mail to
:
Executive Secretary's UK
Office
White Cottage, 102 Church Road,
Watford, Hertfordshire,
WD17 4QB, United Kingdom
