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Food Delivery Request Form
For your safety and the delivery person's health please make sure that you do not come in contact with one another to exchange money or to exchange goods
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Name
*
Your answer
Address
*
Your answer
When would be a good time for this delivery?
*
Your answer
How would you like to pay for this? Note that delivery itself is free but you are expected to pay for the groceries and other goods before the delivery person goes to get them.
Cash or check in mailbox
Cash or check in front door
Paypal
Call credit card in at checkout
Pre-paid, you would coordinate this through where you want you groceries
Other:
Clear selection
What do you need to be delivered? Please note that due to grocery store supply levels we may not be able to get exactly what you want but will do our best to get as close to the product as possible.
Your answer
Where would you like the delivery to be left? If selecting other please make sure the place you asking for the goods to be dropped is not a place where the delivery person and you must come in contact, for health reasons.
Front Porch or outside front door
Back Porch
Other:
Clear selection
Submit
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