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A phone and checking account are required for delivery service.

Please fill in the fields below and we will assign your customer number so your account will be set up for deliveries. After you receive your customer number, you can create your initial order and decide what products you would like to have delivered to your home. We are also carrying the metal milk boxes with our logo that you can purchase to keep on your porch for that nostalgic but useful touch if you so desire.

You will receive an email confirmation after you have clicked on the submit button at the bottom of this form. If you do not receive this confirmation, please resubmit this form.

First Name:
Last Name:
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Retype email address:
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Rural Directions/ Comments:
Check any items that interest you	Glass bottled milk
	Glass bottled chocolate milk
	Glass bottled organic milk
	Bottled water
	Yogurt
	Soda
	Orange juice
	Ice cream
	Chocolate items
	Frozen pizza/dinners
	Bread
	Eggs
	Cheese
	Mr Milkman milkbox
Other items: