2015 Associate Industry Member Application National Association of Wine Retailers 621 Capitol Mall, Suite 2500, Sacramento, CA 95814 Phone: (707) 266-1449 / Fax: (916) 442-0382 www.nawr.org Please complete by printing or typing all information: Organization: Name: Title: Address: City: Phone: ( State: ) Fax: ( Email: Zip Code: ) Web site: IMPORTANT: Please mark your organization’s preferred level of disclosure of its name as an NAWR Member: __ Public __ Semi-private (NAWR members, contributors and Board/Committee members only) __ Private (NAWR Board/Committee members only) ORGANIZATION INFORMATION (please complete): Year Business Established: _______ In which US states does your organization have a presence? _______ How would you describe/categorize your organization? _________________________________________ ____________________________________________________________________________________ ASSOCIATE INDUSTRY MEMBERSHIP INFORMATION: Companies or organizations that support the purpose and goals of NAWR. Annual membership dues are $1,500. The organization is the member, and Associate Industry Members are nonvoting members. In addition, all NAWR members are asked to include an “importance commitment” to their base membership dues. The amount of the “importance commitment” may be based on your annual revenue or the estimated importance of protecting current and/or opening up new direct shipping states. The organization is considered the member, and Associate Winery members are nonvoting members. PAYMENT FREQUENCY (check one): Associate Industry Membership dues may be paid quarterly (4 payments of $375), semi-annually (2 payments of $750), or annually (1 payment of $1500). Invoice quarterly Invoice semi-annually Invoice annually Base Dues: $ 1500.00 Commitment Dues: $ Total Amount Enclosed: $ (please fill in additional “importance commitment” amount) Please make checks payable to "National Association of Wine Retailers". Pursuant to the 1993 Federal Tax Act, it is estimated that 0% of NAWR’s 2015 annual dues will be used to support NAWR’s 2015 California direct lobbying effort. Therefore, this portion of your NAWR 2015 dues may be considered non-deductible for tax purposes. Please return completed application to NAWR at the above address. rev. 4/2015
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