Winery Participation 

Form 

 DUE NOVEMBER 1, 2018

QUESTIONS? Please Contact:

Jennifer Waight, Restaurant & Winery Coordinator

jwaight@lifehouseagency.org

WINE MAKER NAME *
WINE MAKER NAME
CONACT NAME *
CONACT NAME
PHONE *
PHONE
Please indicate if you would like to be located by a particular restaurant. Every effort will be made to accommodate requests based on date of request. Due to space limitations however, we cannot guarantee accommodation of all requests.
WINERY LOGO *
Check all that apply. Please email logos to Jennfier Waight, jwaight@lifehouseagency.org
WINEMAKER PHOTO *
Check all that apply. Email photos to Jennifer Waight, jwaight@lifehouseagency.org.
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