Lake Country Co-op Nipawin Food Store Order Form

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A Lake Country Co-op membership is required to continue. Sign up for your Lake Country Co-op membership HERE or click "NEXT or -->" if you are already a member. PLEASE NOTE: Orders that contain a non-valid member number will be deleted and WILL NOT be processed.

We guarantee same-day delivery, Monday to Sunday. If the order is submitted by 9:00am then the order will go out at 11:00am and if the order is submitted by 2:00pm then the order will go out at 4:00pm. Any order received after 2:00pm will not be guaranteed same-day delivery.

Browse the current flyer HERE.

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Lake Country Co-op Number* This field is required.

Lake Country Co-op membership required to continue.

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Phone Number* This field is required.

Area Code

Phone Number

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Full Name* This field is required.

First Name

Last Name

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E-mail* This field is required.

example@example.com

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Pickup or Delivery? (You will be contacted for your pickup or delivery window.)* This field is required.

Pickup

Delivery

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Address* This field is required.

Street Address (include apartment number, if applicable)

Town

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Do you live at a Seniors or Assisted Living Complex?* This field is required.If yes, we will contact you for special delivery instructions.

YESNO

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Due to limited supply, substitutions may be required. Will you accept substitutions processed at current shelf price?* This field is required.

YESNO

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Method of Payment?* This field is required.

Credit (Visa/Mastercard/AMEX)

Other (Cash/Cheque)

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Produce - Fruit and Vegetables (quantity, type, description)

ex: 3 hothouse tomatoes

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Deli (quantity, type, description)

ex: 1 small package of Grimm's salami

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Bakery (quantity, type, description)

ex: 2 whole wheat store-made sliced bread

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Meat and Seafood (quantity, type, description)

ex: 1 Warehouse Pack boneless, skinless chicken breast

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Dairy, Eggs, and Cheese (quantity, type, description)

ex: 1 - 18 pack Centsibles eggs

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Health and Beauty(quantity, type, description)

ex: 1 tube Colgate toothpaste

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Cleaning Supplies or Paper Products (quantity, type, description)

ex: 1 bottle Dawn dishsoap

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Cereal and Baking(quantity, type, description)

ex: 2 bags of Co-op Gold mini marshmallows

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Grains, Pasta, and Sides (quantity, type, description)

ex: 1 bag of brown basmati rice

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Canned Goods (quantity, type, description)

ex: 3 cans of Campbell's cream of mushroom soup

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Condiments and Spices (quantity, type, description)

ex: 1 large bottle of Heinz ketchup

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Chips, Pop and Snacks(quantity, type, description)

ex: 2 bags of Co-op Gold dill pickle potato chips

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Frozen Foods (quantity, type, description)

ex: 1 large bag of Green Giant frozen peas

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Notes or Extras(special requests, anything extra, etc.)

ex: 1 -4L jug of distilled water

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Terms and Conditions* This field is required.

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Every order will be contacted with a pickup or delivery window time. DO NOT show up for pickup unless we have contacted you.* This field is required.

Yes, I understand that I will be contacted with my pickup or delivery window time.

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Please verify that you are human* This field is required.

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Once submitted, your order will be sent to our NIPAWIN Food Store. You will be contacted with the total and for your pickup or delivery window.

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