HOMEplate Online Order Form

Grocery Pick up Form

Ordering Form
Due to COVID-19 and the increased demand for products we cannot guarantee you will get a specific brand or size of any particular item. If you are not okay with receiving other brands, we urge you not to order at this time until products become in normal stock quantities. We want to ensure a great Delivery so we will do our best!

Please also understand there are limits at some grocery stores so be mindful and try to only order what you NEED. If an item is unavailable you will not be charged for that item.

Delivery times are based on the current demand and will be fulfilled as soon as possible.
Pick up Details
Full Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number *

Area Code Phone Number
E-mail
Do have our "El Torito" loyalty card?

Yes, with number listed above. No, I do not have it and would not like to have it. No but please enroll me now. Yes but it's under the following number
When do you need it?

Chose a date and time you want us to have it ready by. Due to high volume of orders at this time we need at least a hour to prepare your order.
Date

Month Day Year
Date
Time

: Hour Minutes AM/PM Option
Would you like us to take groceries to your car?

Yes No
Once we have your order together we will call you with a total and ask how you want to pay. Over the phone with a credit card only or cash or card when you arrive.
What would you like?

Please use following departments and be as specific as possible, if there is a item we do not have we will call you to ask if you want something similar. Please write items in a list form. We will call you with a total as soon as we have it.
Beverages
Bread and Bakery
Breakfast and Cereal
Canned Goods and Soups
Condiments/Spices
Cookies, Snacks, and Candy
Dairy, Eggs, and Cheese
Buffet
Frozen Foods
Produce: Fruit and Veggies
Grains, Pasta, and Sides
Meat, Deli and Seafood
Miscellaneous – gift cards/wrap, batteries, etc.
Paper Products – toilet paper, paper towels, tissues, paper plates/cups, etc.
Cleaning Supplies – laundry detergent, dishwashing soap, etc.
Health & Beauty, Personal Care: shampoo, toothpaste, soap, etc.
Notes (anything extra, special requests, etc.)
Should be Empty:

Grocery Pick up Form

When do you need it?

What would you like?