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* Restaurant Name:

Hotel / Resort:

* Contact Name and Title:

* Mailing Address:

* City:

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Street Address is same as Mailing

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* City:

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Postal Code:

* Country: United States United Kingdom Canada France Australia Austria Germany Japan Mexico Afghanistan Albania Algeria Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil British Virgin Islands Bulgaria Burkina Faso Burundi Cambodia Cameroon Cape Verde Cayman Islands Central African Republic Chad Chile China Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland French Guiana French Polynesia Gabon Gambia Georgia Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guatemala Guinea Guinea Bissau Guyana Haiti Honduras Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Ivory Coast Jamaica Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent/Grenadines Samoa San Marino Saotome and Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovak Republic Slovenia Solomon Islands Somalia South Africa South Korea Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Uganda Ukraine United Arab Emirates United States Virgin Islands Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Western Sahara Yemen Yugoslavia Zaire Zambia Zimbabwe

Sommelier:

Wine Director:

General Manager:

* Owner(s):

* Contact Email:
(To receive confirmation of receipt of materials and other information from Wine Spectator)

* Reservation Phone:

* Business Phone:

FAX:

Website:

* Total number of selections on wine list:

* Total number of bottles in wine inventory:

Corkage fee per bottle if allowed (in US$):

* Are you a private club?: Yes No

* Dinner entree price range in $US: $ to $

* Prix Fixe menu offered?: Yes No

* Prix Fixe menu only?: Yes No

* Cuisine Type:

Chef:

* Credit Cards (check all that apply): AMEX MasterCard Visa Discover None

* Meals offered (check all that apply): Lunch Dinner

Days closed:

Open Table ID number:

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