Order form v2

Order form for home delivery & curbside pickup

Delivery available Monday to Friday. Curbside pickup available every day. Please ensure to have this form completed and sent by 10am to increase your chance of same-day service. We will review your order, call to discuss any details and to take payment by Visa or MasterCard once your order is ready. Questions? Tel. 613-256-4545 Email: order@dandelionfoods.ca.
Name *

First Name Last Name
Phone Number *

Area Code Phone Number
Email *
example@example.com
Order Collection Method *

Local delivery Curbside pickup
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Any special delivery instructions
CREATING YOUR ORDER

Below you will choose the department (e.g. Vegetables) and then enter items individually.

Please be as specific as possible, for example:

2 x Sunflower hummus (regular flavour)

1 x bag of golden raisins (approx 1lb, dark raisins are okay too)
Please enter your order details below
Choose 1st department *
1. Enter an item and click "add more" for the next item (e.g. 2 x hummus) *
1. Select new department

Yes
Choose 2nd department
2. Enter an item and click "add more" for the next item (e.g. 2 x hummus)
2. Select new department

Yes
Choose 3rd department
3. Enter an item and click "add more" for the next item (e.g. 2 x hummus)
3. Select new department

Yes
Choose 4th department
4. Enter an item and click "add more" for the next item (e.g. 2 x hummus)
4. Select new department

Yes
Choose 5th department
5. Enter an item and click "add more" for the next item (e.g. 2 x hummus)
5. Select new department

Yes
Choose 6th department
6. Enter an item and click "add more" for the next item (e.g. 2 x hummus)
6. Select new department

Yes
Choose 7th department
7. Enter an item and click "add more" for the next item (e.g. 2 x hummus)
7. Select new department

Yes
Choose 8th department
8. Enter an item and click "add more" for the next item (e.g. 2 x hummus)
8. Select new department

Yes
Choose 9th department
9. Enter an item and click "add more" for the next item (e.g. 2 x hummus)
9. Select new department

Yes
Choose10th department
10. Enter an item and click "add more" for the next item (e.g. 2 x hummus)
Anything else we need to know?
Please verify that you are human *
Should be Empty:

Order form for home delivery & curbside pickup