INMATE Curbside Order Form

Curbside Order Form

Walmart Inmate Order Form
Kindly complete this form after you have finished placing your curbside order on Walmart.com. Once the form is submitted, we will receive notification of your order. You have the flexibility to schedule your pick-up at any day and time, unless otherwise specified that pick-ups are not available on certain days. Please note that orders for perishable packages should be placed before Monday to guarantee delivery within the same week.
Inmate Name*

First NameLast Name
DIN Number *
Inmates Facility
Senders Information *

Name

Address

CityState / Province

Postal / Zip CodeCountry
Contact Phone Number *
PLEASE MAKE SURE YOUR PHONE NUMBER IS CORRECT IN CASE THERE ARE ANY ISSUES
Email*
****PLEASE PUT THE EMAIL THAT'S AFFILIATED WITH YOUR WALMART ORDER****
Date Of Pick Up *

MonthDayYear
Date
Time Of Pick Up *

Hour Minutes

AM/PM Option
Upload Screen Shot Of Walmart Order Number *

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Upload Screen Shot of Cash App, Apple Pay, Zelle Payment

Please include Name and DIN NUMBER for all payments made
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My Products
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Shipping & Handling Fee CLICK THIS OPTION ONLY TO PAY WITH DEBIT OR CREDIT CARD
$115.00



*****Perishables cooler ******If you have perishable we recommend getting a cooler to place perishables in. We will provide free ice packing with this purchase
$10.00 Quantity



Cash App, Zelle, Or Apple Pay Payments Click this option ONLY. If you need to pay with one of these payment methods Please Attach a screen Shot of your payment method above.
$ Free Quantity



Total

$0.00
TERMS & CONDITIONS

"ORDERS FOR PERISHABLE PACKAGES MUST BE PLACED BEFORE MONDAY TO ENSURE SAME WEEK DELIVERY"

PLEASE NOTE THAT THE TIMING OF PACKAGE DISTRIBUTION BY FACILITIES IS BEYOND OUR CONTROL. IF THE SHIPMENT SAYS DELIVERED, PLEASE CONTACT THE FACILTY FOR PACKAGE DELIVERY QUESTIONS.

***ALL PACKAGES ARE SHIPPED FRESH AT THE TIME OF SHIPMENT AND MAINTAINED IN OPTIMAL CONDITION DURING TRANSIT***

WE ARE NOT RESPONSIBLE FOR MISSING OR SPOILED ITEMS. PLEASE BE INFORMED THAT ALL ITEMS UNDERGO THOUROUGH CHECKS DURING THE PACKAGING PROCESS TO ENSURE ALL ITEMS ARE PACKAGED. IF WALMART FAILS TO GIVE ANY ITEMS DURING PICK UP, WE WILL EMAIL YOU WITH ANY ERRORS SO YOU CAN REQUEST A REFUND FROM WALMART, FOR THE MISSING ITEMS. WE WILL NOT REPLACE ANY MISSING WALMART ITEMS ON OUR BEHALF.

We are not responsible for any situation where the package is refused or held up or if perishable items spoil. For Example:

There is a delay in the mail room
The inmate is out to court
The inmate has lost package room privileges
The inmate has a situation that does not allow packages to be delivered
The inmate is over allowable package limit
The inmate is transferred to another facility
The inmate refuses the package

If a package is returned to our company for any reason, we will contact you to make arrangements for reshipment, or return of the package.
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