Fill in the form below (* are required fields).

Minimum delivery order is $35. A $20 refundable box deposit is charged on the first delivery

First Name:*
Last Name:*
Home Phone:*	Other Phone:
Email Address:*
Street Address:
Unit #:
City:
Postal Code:

Driving Directions: (anything tricky)

How did you find our service?

How often would you like to receive the box?
weekly every second week

Where would you like us to leave your box?
(eg. front door, back door, porch)

How do you want to pay?
(If you want to pay by credit card, we will call to get your visa # on file.)
Cheque/Cash   Visa/MasterCard

Where can we find the first cheque?
(ex. under the mat, taped to the door, in your mailbox)

When would you like to start?

Comments or Questions?

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