Name *

First Name

Last Name

Business Type *

Please check all boxes that apply to your business.

Winery - No Tasting Room

Winery - With Tasting Room

Winery with one or more brands

Winery - Bulk Wine & Services Mainly

Package, Chemical, or Supply to Wine Producer

Service Supplier - Technical Consulting

Service Supplier - Marketing Services

Services Suppler - Graphic Arts and/or Digital Film Media

Service Supplier - Warehousing

Service Supplier - Compliance Services

Service Supplier - Direct to Consumer/Social Media

Wine Retailer - Specialty

Wine Retailer - General Grocery

Wine Wholesaler

Sales Organization - Other

Wine Brokerage

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Category of Interest

Market Intelligence Project

Geographic Mapping Support

Survey or other Marketing Research

Film Media Development

Contact Relationship System Development

Other