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VIRGIN BLOCK WINE ORDER FORM     
Name * Occupation
Address * Suburb *
State Postcode *
Country Telephone (hm) *
E-mail * Telephone (wk)
* required  

Wine Range
Special Price/Case
Quantity
  
2004 Semillon Savignon Blanc
$205.20
2002 Shiraz
$248.40
2003 Shiraz
$248.40
2002 Cabernet Merlot
$248.40
2003 Cabernet Merlot
$248.40
Mixed Case
$234.00
 
Credit Card Payment Option

By clicking the button below, you'll be forwarded to
a secure site to enter your credit card details.

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We dispatch orders with in 5 working days, however arrival is subject to transport scheduling.
If you are not completely satisfied with an item you have purchased, Virgin Block is happy to honour your request with an exchange or refund.
Your Contact Details will be processed and forwarded to BankWest by a provider of data processing services. No record of your name or card details will be retained by the services provider after being forwarded to BankWest. By approving the transaction you authorise the processing of your transaction in this manner. If you would prefer to make your payment in some other manner please contact Virgin Block directly.