Grocery & Cargo Service Request

Please verify with the store that the order is ready for pick up before completing this request form.

All pickups take place on Fridays between 9am and 11am.

Pick-up Date

Name of the person the order is placed under *

First Name Last Name

Full Name

Customer ID

This will automatically be filled in if you have signed up for an account over 24 hours ago

Email *

example@example.com

Contact Number

Please provide a phone number where we can reach you if there are any problems picking up your order

Delivery Location *

Savary Dock Hernando Dock Other

Special Arrangement: Different Delivery Day?

Yes!

Details of Special Request Regarding Delivery Day

Delivery Address

Street Address

Street Address Line 2

City

Postal / Zip Code

Please choose your stores for pick up and indicate order/confirmation no. *

Store Name #1

Order/Conf No. #1

Store Name #2

Order/Conf No. #2

Please upload your order confirmations

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Emails can be printed as PDFs and uploaded here

Notes for Driver