Jersey Juice Bar: Purchase & Payment Form

Thank you for choosing Jersey Juice!

Please read our FAQs carefully before purchasing

To make your ordering process smoother, please follow these simple steps to fill out our menu order form:

Browse our menu and locate the items you wish to order.
For each item, enter the quantity you'd like to order in the designated box.
Before submitting, take a moment to review your order details making sure your contact information, order quantities, and any special requests are accurate.

Contact our customer service at welovejerseyjuice@gmail.com for any questions before you submit this form.

If you select 3 juices, please use code TRISTATE for $6.00 off.
If you select 6 juices, please use code PTOWN for $12.00 off.
If you select 9 juices, please use code UPTOP for $18.00 off.

Fill in your full name, email address, and phone number.

Name*

First NameLast Name

Email*

example@example.com

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

PickupDelivery

Delivery is available within Maryland & DC up to 25 miles from 20716 for an additional fee. Delivery charges may vary based on distance. Someone must be present at the delivery location to receive the order during the scheduled delivery window.

Please select desired date for pickup/delivery. Please note that same day pick-ups and deliveries are not available.*

Date

If choosing delivery,provide accurate delivery information to ensure successful delivery and any specific delivery instructions if needed in the comments section. We are not responsible for delayed or undelivered orders due to inaccurate details.

Delivery Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

If you have any dietary restrictions, allergies, or special requests, please specify them in the provided section. We'll do our best to accommodate your needs.

Comments

Please verify that you are human*

Payment must be made at time of order. Orders will be processed during our operating hours. Any orders placed outside of our operating hours will be processed on the next business day. You will receive a confirmation emailwith your order details and any additional instructions once your payment has been processed.

Order cancellations or modifications can be requested before the order preparation has begun. Contact our customer service at welovejerseyjuice@gmail.com for assistance.

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