Big B Delivery Order Form ORIGINAL

COUNTDOWN TO ARMY - NAVY FOOTBALL
Send Your Delivery Order Below :
Full Name :*

First NameLast Name
Phone Number :*
Where did you order from ?*
WALGREENS orders need to be READY FOR PICK UP. ( they do the shopping )
Did you place the order in the EXACT name as above ?*

YESNO
EXACT Name(s) Order placed under : ONLY IF MORE THAN 1 LIST THEM ALL
Please make sure this is EXACT or they’ll be looking for your order all night. If it’s SAME as above you can just write SAME.
Order # : *
* ONLY the 1st 4 characters needed. 1) Select PICKUP 2) Click ARRIVED. 3) pickup COUNTER
Does your order come with ANY DRINKS?*

NoYES
How many drinks did you order ?*
Not including McFlurry or Shakes
What BOTTLE / FOUNTAIN DRINK did you order ?*
This is for FOUNTAIN DRINKS
What FOUNTAIN DRINK did you order ?*
This is for FOUNTAIN DRINKS
What TIME did they say it would be READY ?*

Hour Minutes
Where would you like your order delivered?*
PLEASE - PLEASE BE ON TIME - Thank You
Special Delivery Instructions :
* Delivery Fee $6.00 *

Tips Are Always Gratefully Appreciated

PAY with buttons below

THEN Click to Send Delivery Info
Raise your right hand - Before you hit submit. Are you going to remember to RESPOND , PAY the delivery / tip fee & BE ON TIME ?*
This form will be unavailable to submit outside our business hours of

5:00 pm - 9:00 pm

See You On Your Next Delivery
Time

Hour Minutes

AM/PM Option
Should be Empty:

Send Your Delivery Order Below :