Application may be made by phone, fax, or E-mail
115 West Pacific Avenue * Spokane, WA 99201
Phone & Fax: (509) 363-1353
info@robertkarl.com
Health Club
You must be 21 or older to join.
Shipping Address:
NAME______________________________________________
ADDRESS___________________________________________
ADDRESS___________________________________________
CITY________________________ STATE______ ZIP________
PHONE_____________________________________________
EMAIL_____________________________________________
Payment Information: VISA______ MasterCard______
Card #___________________________________________________
Exp. Date___________________
Billing Address (if different):
NAME______________________________________________
ADDRESS___________________________________________
ADDRESS___________________________________________
CITY_______________________ STATE______ ZIP_________
2 Bottles____ 4 Bottles____ 6 Bottles____ 12 Bottles____
Pick Up at Winery ____ Ship____
Your credit card will be billed for the wine and shipping
at the time of shipment.
Your membership may be canceled at any time prior to shipment.
