CREATE YOUR MEMBERSHIP PROFILE

Divas Uncorked welcomes you to our network. Simply complete the membership profile and you are part of a growing network of wine enthusiast. You will receive regular e-mails about upcoming activities and great opportunities to explore wine – DIVAS style.

First Name: Last Name: Street: City: State: Choose your state Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip: Country: USA International E-mail: Your e-mail address will be your login ID to access members only information at www.divasuncorked.com. Birthdate: Gender: Female Male Ethnicity: Choose your ethnicity African-American Asian/Pacific Islands Hispanic American Indian White Other Employment: Choose your employment status Employed full time Employed part time Self-employed Student Homemaker Retired Unemployed Disabled Volunteer Other Education: Choose your education level Some High School High School Graduate Some College College Graduate Some Post Graduate Post Graduate Other Household income: Choose your income range $25,000 and below $25,001 - $34,999 $35,000 - $49,999 $50,000 - $74,999 $75,000 - $149,999 $150,000 and above Marital status: Choose your marital status Single Married Divorced Domestic Partner Widowed Number of children: Select 0 1 2 3 4 5 6 or more Favorite wine varietals: Choose your favorite Cabernet Chardonnay Chenin Blanc Malbec Merlot Pinot Noir Pinot Grigio Rosé Sauvignon Blanc Shiraz ? Syrah Viognier Zinfandel White Zinfandel Other Would you like to participate in occasional surveys that we might perform for our partners from the wine business? On occasion our partners in the wine business have special offers for our members. Do you want to receive e-mail notification of such offers?