Curbside Pick Up Form
Please enter 1 item per entry field (up to 20 items total)
If you require fewer than 20 items, leave remaining entry fields blank and click "next" at the bottom of the screen until you come to the end of the list where you may submit your order.
Owner Number/ FFA# (not required)
Phone Number (xxx)xxx-xxxx
Car Make, Model and Color
Is this your first curbside pick up order?
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This form was created inside of River Valley Market LLC.