New Customer – Lucas & Lewellen Vineyards Online Store

New Customer

Please specify your contact information. You will have the opportunity to enter separate billing and shipping information on the next screen. Read our Privacy Policy

This update form applies to your website user account only.

If you would like to use the information you have provided on this form to update your Wine Club account, please send an email to Anjie@LLWine.com so that we will know to look for the updates.

First Name:

Last Name:

Phone Number: Why is this needed?

Phone Ext: (optional)

E-Mail Address: Why is this needed?

E-Mail Address: Re-type to confirm

Date of Birth:(mm/dd/yyyy)

Address Line 1: (or Company Name)

Address Line 2: (optional)

City:

State/Province:

Zip/Postal Code:

Country:

Address Type:

Business Residential

This is my Preferred Ship-To Address

This is my Preferred Bill-To Address

If you wish, you may create a password for use in the Lucas & Lewellen Vineyards Online Store. Password is optional, but if you do create one it must be at least 7 characters long and contain at least 1 letter and at least 1 non-letter (i.e. number or punctuation character), and may not contain spaces.

Password: (optional)

Password: Re-type to confirm

(805) 686-9336

Anjie@LLwine.com

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