SBFM Curbside Order Form 2021
South Bend Farmer's Market Curbside Order Form 2021
Email address *
Customer Name ( First and Last Name) please *
Make and color of vehicle picking up groceries *
Phone Number - so we can text you with questions or let you know your order is ready *
Date order is placed**** Please note: If you place your order after 2:30 on Tuesday - please pick up on Thursday, after 2:30 on Thursday - please pick up on Saturday; after 2:30 on Saturday - please pick up on the following Tuesday. THANK YOU *
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Date I would like to pick up my curbside order *
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I would like to pick up my SBFM Curbside order between..... Pick-up your curbside order at DOOR C at the time and date requested. *
Text me with the amount owed when my order is ready *
How will you be paying for your curbside groceries and service. Please note a $3.00 service fee is added to your total to cover bags and other costs.
Clear selection
First Item *
Quantity of first item *
Packaging of first item *
Preferred vendor for first item. ** if left blank, the Market shopper will choose.
Second Item
Quantity of second item
Packaging of second item
Clear selection
Preferred vendor for second item. ** if left blank, the Market shopper will choose.
Third Item
Quantity of third item
Packaging of third item
Clear selection
Preferred vendor for third item. ** if left blank, the Market shopper will choose.
Fourth Item
Quantity of fourth item
Packaging of fourth item
Clear selection
Preferred vendor for fourth item. ** if left blank, the Market shopper will choose.
Fifth Item
Quantity of fifth item
Packaging of fifth item
Clear selection
Preferred vendor for fifth item. ** if left blank, the Market shopper will choose.
Sixth Item
Quantity of sixth item
Packaging of sixth item
Clear selection
Preferred vendor for sixth item. ** if left blank, the Market shopper will choose.
Seventh Item
Quantity of seventh item
Packaging of seventh item
Clear selection
Preferred vendor for seventh item. ** if left blank, the Market shopper will choose.
Eighth Item
Quantity of eighth item
Packaging of eighth item
Clear selection
Preferred vendor for eighth item. ** if left blank, the Market shopper will choose.
Ninth Item
Quantity of ninth item
Packaging of ninth item
Clear selection
Preferred vendor for ninth item. ** if left blank, the Market shopper will choose.
Tenth Item
Quantity of tenth item
Packaging of tenth item
Clear selection
Preferred vendor for tenth item. ** if left blank, the Market shopper will choose.
I need other items from the South Bend Farmer's Market - include as much information as possible, please
Additional information, note and/or comment
A copy of your responses will be emailed to the address you provided.
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