Grocery Pickup Check-In Form
Please complete this Grocery Pickup Check-In Form to let us know you have arrived to collect your grocery order.
Full Name
*
First Name
Last Name
Order Number
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Pickup Location
*
Please Select
Main Entrance
Curbside Pickup Zone
Designated Parking Area
Other
Arrival Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Vehicle Make and Model
Vehicle Color
Parking Spot Number (if applicable)
Are substitutions for out-of-stock items acceptable?
*
Yes, substitutions are okay
No, please do not substitute
Assistance Needed or Special Instructions
Check In
Should be Empty: