Grocery Delivery Form

Bulk Delivery Form

Please fill out the form to to get your BULK groceries delivered to your home, hotel, condo, or vacation rental. Both Bulk warehouses, Sam's Club and Costco are 1 hour and 30 min away in either direction.
Full Name*

First NameLast Name
Email Address*

Confirmation Emailexample@example.com
Phone Number*
Please enter a valid phone number.
Delivery Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Select the one that applies to your delivery...

I have ordered my groceries online and require pickup and delivery.There are specific items I need you to pickup in bulk and delivery them.
Choose Your Bulk Grocery Store:

Sams Club Johnson City TN - 3060 Franklin Terrace, Johnson City, TN 37604Sams Club Hickory NC - 2435 US Hwy 70 SE, Hickory, NC 28602Costco Wholesale - 392 Talbert Rd, Mooresville, NC 28117Costco Wholesale - 1085 Hanes Mall Blvd, Winston-Salem, NC 27103Farmer John's Produce - 2100 W Elk Ave, Elizabethton, TN 37643Valley Forge Wholesale - 412 Cherokee Park Dr, Elizabethton, TN 37643
Date & Time of Grocery Order*

MonthDayYear
Date
Date & Time of Grocery Pickup*

MonthDayYear
Date
Hour MinutesAM/PM Option
Payment for Bulk Delivery
- Sam's Club Delivery 1x per week $75
- Sam's Club Delivery 1x per month $90
- Costco Runs 1x per week $100
- Costco Runs 1x per month $125
- Valley Forge & Farmer Johns Delivery 1x $65 per week
- All Sams Club & Costco Runs are invoiced separately and are paid upon delivery via online invoice or by mobile terminal.
- Personal or Busniess Pickup Available.
- Spots are limited so get yours on the calendar and save time for yourself and your business.
AYC Delivery drivers will pickup your items, delivery them and carry them inside.

Cash tips are appreciated by your driver upon delivery or during the holidays!

If you require any special instructions for bulk delivery, such as multi- pickup at Sam's Club and Costco, or have any questions please contact Rob at 828-900-9466 for more information.
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Bulk Delivery Form