Remote Sales Form

1
What's your team name?* This field is required.
2
What's your first and last name?* This field is required.
3
What's your email address?* This field is required.
jane@gelvio.com
4
What date does your team want to start snacking?* This field is required.
Date
Year
Month
Day
5
What’s your budget per person?* This field is required.Shipping is free for orders over $49.00, otherwise recipients pay standard shipping of $5.95.
$30
$50 (Popular)
$75
$99
6
How many recipients on your team?* This field is required.
7
How often do you want recipients to receive a Gelvio snack budget?* This field is required.Make team snacks a one-time thing or recurring. At anytime you can update cost, frequency, active team members or simply cancel.
Every 4 weeks
Please select frequency
One-time
Every 2 weeks
Every 4 weeks
Every 6 weeks
Every 8 weeks
Every 12 weeks
8
Add a message for recipientsRecipients will receive this message in an email.
9
Upload list of recipients (Option 1)Your CSV file should have one column for email addresses.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
10
Add email addresses for recipients (Option 2)Format example: jane@gelvio.com,doe@gelvio.com
11
Payable amount
12
Total cost for your order* This field is required.
prevnext( X )
USD
+ OR enter a custom value
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Should be Empty: