Kiara Wine Club

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How to Join the Club?

The membership fee for joining the Club is Rs.3000/-.

You can send your cheque to the following address :

Kiara Wine Club
Adarsh Icecream Compound
B.J. Patel Road,
Malad (W). Mumbai – 400 064. Maharashtra, India.
Tel : (022) 28820743
Cell : (022) 33973649
E-mail : contact@kiarawines.com
ravishkumarahuja@yahoo.com

Make sure you fill in all the information requested in the accompanying membership application form.

Membership Application

My Name

Date of Birth

Date

Month

Year

My Mailing Address

City

Telephone No. (Res.)

Mobile

E-mail ID

Name of Co./Business

Co./Business Address

Telephone No. (Off)

Fax

Spouse's Name

Date of Birth

Date

Month

Year

Date of Anniversary

Date

Month

Year

Mobile

E-mail ID

Co./Business Address

Telephone No. (Off)

Fax

Details of Children	M/F	Name	Age
1)
2)
3)

Hobbies :	Personal	1)
		2)
	Spouse	1)
		2)

Drinks (If Any) : Preference

Personal

Wine

Beer

Whisky

Brandy

Cocktails

Spouse

Wine

Beer

Whisky

Brandy

Cocktails

Food Type : Preference

Personal

Indian

Chinese

Italian

Continental

French

Thai

Spouse

Indian

Chinese

Italian

Continental

French

Thai


Entertainment Preferred
Personal	Movies	TV	Theatre	Live Bands	Others
Spouse	Movies	TV	Theatre	Live Bands	Others

Sports Interest
Personal	Cricket	Golf	Tennis	Soccer	Others
Spouse	Cricket	Golf	Tennis	Soccer	Others