Name
Title/Position
Winery Name
Are you bonded in WA?
Yes
No
TTB ID #
Organization Name (if not winery)
Address
City
State
ZIP
Phone
Fax
E-Mail
Web Site
Production Level (in gallons)
Membership Type
Regular
Associate
Affiliate
Industry
Dues Contribution (in dollars)
Any issues or items you want to
bring FWWS board attention to?
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