Jekyll Market Grocery Order Form
Name: ___________________________________________
Delivery Address: __________________________________ ________________________________________________
Tel _____________________ Del Time: ________________
Credit Card: ______________________________________
Expiration: __________ Code: _______________________
Fresh Fruits & Vegetables:
__ Apples (Red or Green) Qty: _______
__ Oranges Qty: _______
__ Bananas Qty: _______
__ Grapes (Green or Red) Qty: _______
__ Strawberries Qty: _______
__ Lemon or Lime Qty: _______
__ Lettuce Qty: _______
__ Cucumber Qty: _______
__ Tomatoes Qty: _______
__ Bell Pepper Qty: _______
__ Carrots Qty: _______
__ Celery Qty: _______
__ Avocado Qty: _______
__ Potatoes (Idaho or Red) Qty: _______
__ Sweet Potato Qty: _______
__ Other Qty: _______ _______________________________________________
Dairy:
__ Milk (Skim,2%, Whole) Qty: _______
__ Half ‘n Half or Heavy Cream Qty: _______
__ Cream Cheese Qty: _______
__ Sour Cream Qty: _______
__ Eggs Qty: _______
__ Butter or Margarine Qty: _______
__ Yogurt Qty: _______
__ Shredded Cheese Qty: _______
__ Other Qty: _______ _______________________________________________
Deli:
__ Sliced Meat Qty: _______
__ Sliced Cheese Qty: _______
__ Prepared Salads Qty: _______
Pick Meats: __Ham __ Turkey __ Chicken __ Salsalito Turkey __ Buffalo Chicken __Curried Chicken __ London Broil __ Corned Beef __ Pastrami __ Pepperoni __ Capicola __ Genoa Salami
Pick Salads: __ Tuna Salad __ Shrimp Salad __ Chicken Salad - Homestyle or Pesto __ Pimento Cheese (Reg or Jalapeno) __ Lobster Sensation
Pick Cheeses: __ Cheddar __ Swiss __ Provolone __ Mozzarella __ American __ Parmesan __ Havarti __ Pepper Jack __ Smoked Gouda __ Other Qty: _______ ________________________________________________
Bakery:
__ Bread Qty: _______
__ Hotdog or Hamburger Buns Qty: _______
__ Bagels Qty: _______
__ Muffins Qty: _______
__ Cookies Qty: _______
__ Crackers Qty: _______
__ Other Qty: _______ ________________________________________________
Meat/Seafood:
__ Ground Beef Qty: _______
__ Filet Mignon Qty: _______
__ Ribeye Qty: _______
__ Chicken Breast Qty: _______
__ Wild Georgia Shrimp Qty: _______
__ Bacon Qty: _______
__ Sausage Qty: _______
__ Frozen Fish (Cod or Salmon) Qty: _______
__ Other Qty: _______ ________________________________________________
Frozen Foods:
__ Vegetables Qty: _______
__ Pizza Qty: _______
__ Ice Cream Qty: _______
__ Other Qty: _______ ________________________________________________
Snacks:
__ Granola Bars Qty: _______
__ Raisins Qty: _______
__ Apple Sauce Qty: _______
__ Pop Corn Qty: _______
__ Other Qty: _______ ________________________________________________
Spices/Condiments/Baking:
__ Other Qty: _______
________________________________________________ ________________________________________________
Drinks/Beverages:
__ Bottled Water (24 pk) Qty: ________
__ Other Qty: _______
________________________________________________ ________________________________________________
Canned/Dry Items:
__ Other Qty: _______
________________________________________________ ________________________________________________
Supplies: __ Other Qty: _______
________________________________________________ ________________________________________________
Toiletries __ Other Qty: _______
________________________________________________ ________________________________________________
Miscellaneous
________________________________________________ __ Other Qty: _______ ________________________________________________ ________________________________________________ __ Other Qty: _______ ________________________________________________ ________________________________________________ __ Other Qty: _______ ________________________________________________ ________________________________________________ __ Other Qty: _______ ________________________________________________ ________________________________________________ __ Other Qty: _______ ________________________________________________ ________________________________________________ __ Other Qty: _______ ________________________________________________ ________________________________________________ __ Other Qty: _______ ________________________________________________ ________________________________________________ __ Other Qty: _______ ________________________________________________ ________________________________________________ __ Other Qty: _______
________________________________________________ ________________________________________________ __ Other Qty: _______ ________________________________________________ ________________________________________________ __ Other Qty: _______ ________________________________________________ ________________________________________________ __ Other Qty: _______
Please note that we will endeavor to fill you order as close as possible. Note that there are shortages currently of toilet paper, bleach, antibacterial wipes, milk, bread, paper towels, and other sundries. Please be as specific as possible if you want a particular brand. If it is not available, please note if you will not accept a substitute. For example, if you only like Hellman’s mayonnaise, let us know if you will not accept another brand.
There is a $10 delivery fee for Jekyll Island residents and a $75 minimum order. We will box groceries and leave for you on the porch or covered entryway. Someone must be home to receive the order, but personal contact is not necessary. Your credit or debit card will be charged prior to delivery. No cash accepted by drivers. Call in orders are not accepted due to high volume of store traffic. Print a copy and snap a picture of your order with your phone and email to jekyllmarket@gmail.com