2015 Retailer 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:
State:
Phone: (
)
Fax: (
)
Email:
Web site:
Zip Code:
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/Membership Committee members only)
ORGANIZATION INFORMATION (please complete):
Year Business Established: ____ Number of Locations: ____
In which US states does your organization have a presence? ____________________________________
How would you describe/categorize your organization? _________________________________________
MEMBERSHIP INFORMATION: Your organization is the member and each member organization is
entitled to one (1) vote.
RETAILER MEMBERSHIP DUES: There is a $1000 one-time initiation fee for new members plus monthly
membership dues. The minimum monthly dues are $500. It is critically important that every member who
can, contributes an additional “importance commitment” to this base level. This may be based on your
annual revenue, your percentage of direct shipments and/or the importance of protecting current and/or
opening up new direct shipping states for wine retailers. For example, on average NAWR members
currently pay $1,000 per month which equals $500 in base dues + $500 in “importance commitment.”
2015 Dues Formula
Initiation Fee
Base Dues
Commitment Dues
Total Monthly Dues
$ 1000 one time, plus
$ 500 per mo
______ per mo (please fill in your additional “importance commitment”)
______ per month (please fill in your total monthly commitment)
PAYMENT FREQUENCY (check one):
Membership dues may be paid monthly, quarterly or annually based on the monthly dues amounts above.
 Invoice monthly  Invoice quarterly  Invoice annually
OR  Contribution
Make checks payable to "National Association of Wine Retailers". Total Amount Enclosed (initiation fee
+ initial base dues + importance commitment OR contribution) $
______
Please return completed application to NAWR at the above address.
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 direct
lobbying efforts. Therefore, this portion of your NAWR 2015 dues may be considered non-deductible for tax purposes.