SHOPPING LIST FORM
PRODUCE AISLE
Qty
Description
Apples
Asparagus
Bananas
Beets
Berries
Broccoli
Carrots
Cauliflower
Celery
Cherries
Corn
Cucumbers
Grapes
Greens
Kiwis
Lettuce
Lemons
Limes
Melons
Onions
Oranges
Peaches
Pears
Peppers
Plums
Potatoes
Spinach
Sprouts
Squash
Tomatoes
Zucchini
Other
BAKING AISLE - SPICES & HERBS
Qty
Description
Basil
Black Pepper
Cilantro
Cinnamon
Garlic
Oregano
Parsley
Red Pepper
Salt
Vanilla Extract
Other
MEAT AISLE
Qty
Description
Bacon
Chicken
Ground Beef
Ground Turkey
Ham
Hot Dogs
Lunch Meat
Pork
Sausage
Steak
Turkey
Other
CANNED FOOD AISLE
Qty
Description
Apple Sauce
Baked Beans
Beans
Carrots
Corn
Beans
Mixed Fruit
Mixed Veg
Olives
Pickles
Refried Beans
Tuna
Soups
Tomatoes
Other
SNACK AISLE
Qty
Description
Candy
Cookies
Dried Fruit
Granola Bars
Nuts
Popcorn
Potato Chips
Pudding
Pretzels
Tortilla Chips
Other
MISC. FOOD ITEMS
Qty
Description
Bottled Water
Bullion Cubes
Cereal
Coffee
Gravy
Honey
Pancake Mix
Pasta
Peanut Butter
Ramen
Soda Pop
Tea
White Rice
Other
BABY AISLE
Qty
Description
Baby Food
Baby Food
Baby Food
Baby Food
Baby Food
Baby Food
Diapers
Diaper Lotion
Formula
Wipes
Other
PERSONAL AISLE
Qty
Description
Antiperspirant
Bath Soap
Conditioner
Deodorant
Facial Tissue
Floss
Hair Gel/Spray
Hand Soap
Mouthwash
Q-Tips
Shampoo
Toilet Paper
Toothpaste
Other
CLEANING AISLE
Qty
Description
Air Freshener
Bath Cleaner
Bleach
Dryer Sheets
Fabric Softener
Floor Cleaner
Garbage Bags
Glass Cleaner
Laundry Soap
Spray Polish
Vacuum Bags
Other
PERSONAL INFORMATION
First Name
Last Name
Address Line 1
Address Line 2
Area
Section A
Section B
Section C
Section D
Section E
Area Choice Details
Zip Code
Phone Number
Email Address
I agree and understand that Payment is
expected at the time of delivery.
We accept all major credit cards and debit
cards (with the visa or MasterCard logo)
DAIRY AILSE
Qty
Description
Butter
Eggs
Half & Half
Heavy Cream
Margarine
Milk
Sour Cream
Whip Cream
Yogurt
Other
CHEESE AISLE
Qty
Description
Cheddar
Cott Cheese
Crm Cheese
Feta
Mozzarella
Parmesan
Pepper
Provolone
Ricotta
Sand Slices
Shredded
Swiss
Other
BAKING AISLE
Qty
Description
Baking Powder
Baking Soda
Bread Crumbs
Brown Sugar
Brownie Mix
Cake Mix
Cake Frosting
Chocolate Chips
Cocoa
Flour
Nuts
Oatmeal
Pie Shell
Pwd Sugar
Shortening
Sugar
Syrup
Yeast
Other
OILS / VINEGAR AISLE
Qty
Description
Apple Cider Vin
Balsamic Vin
Olive Oil
Vegetable Oil
White Vinegar
Other
SEAFOOD AISLE
Qty
Description
Cod
Crab
Halibut
Oysters
Salmon
Shrimp
Tilapia
Tuna
Other
SAUCES AISLE
Qty
Description
BBQ Sauce
Hot Sauce
Pasta Sauce
Salsa
Soy Sauce
Steak Sauce
Worcestershire
Other
REFRIDGE / FROZEN AISLE
Qty
Description
Chip Dip
Juice
Rdy Bk Breads
Tortillas
Burritos
Desserts
Fish Sticks
Ice Cream
Pizzas
Popsicles
Fries/Tater Tots
Sorbet
TV Dinners
Vegetables
Veggie Burgers
Other
MISC. FOOD ITEMS
Qty
Description
Jelly/Preserves
Ketchup
Lmn/Lim Juice
Mac & Cheese
Mayonnaise
Mustard
Other
BAKERY AISLE
Qty
Description
Bagels
Bread
Buns
Cake
Crackers
Croissants
Donuts
Pastries
Pie
Rolls
Other
PET AISLE
Qty
Description
Cat Food
Cat Litter
Cat Treats
Dog Food
Dog Treats
Pet Shampoo
Other
MEDICINE AISLE
Qty
Description
Allergy
Antidiarrheal
Aspirin
Antacid
Band-aids
Cold Medicine
Fem Products
Vitamins
Other
KITCHEN AISLE
Qty
Description
Aluminum Foil
Coffee Filters
Dish Soap
Dshwshr Soap
Disp Cups
Disp Cutlery
Disp Plates
Freezer Bags
Napkins
NoStick Spray
Paper Towels
Plastic Wrap
Sand Bags
Scrubbers
Wax Paper
Other