Grocery Order Form


Name *
Name
Phone *
Phone
Delivery Address *
Delivery Address
Delivery Preference *
In the event you are not home during the appointed delivery window, please indicate your delivery preference. Ojai Food Taxi can not assume liability for perishable items or loss when leaving groceries unattended or scheduling redelivery.
Grocery Store *
Please select grocery store below. Each store pickup requires a separate order submission.
Delivery Date *
Delivery Date
Select delivery date.
Delivery Time *
Delivery Time
Indicate preferred delivery time.
Method of Payment *
A credit card number is required in order to process a grocery order. The card will not be charged unless you wish to use it at delivery or you opt to have your groceries left at your home when no-one is present to receive delivery. The credit card number will be requested during order confirmation or you may call Ojai Food Taxi to confirm yourself at (805) 798-4446.
Enter name, billing address and telephone if different from delivery address.
If your order reaches the maximum budget, Ojai Food Taxi will remove items from the list at its discretion. If there are items that are essential, please indicate this in the Special Instructions section below.
$
Discounts
I qualify for the following 7% discount.
My Grocery List *
Indicate how you are sending your grocery list to Ojai Food Taxi.
Instructions to driver, gate code, priority items, etc.
GROCERY ITEM LIST
Organic Foods
Please indicate your preference if desired.
Please list items and their amount needed from this department.
Please list the amount, brand if desired, and product description of items needed from this department.
Please list items and their amount needed from this department.
Please list items and their amount needed from this Department.
Please list items and their amount needed from this department.
Please list items and their amount needed from this department.
Please list items and their amount needed from this department.
Please list items and their amount needed from this department.
Please list items and their amount needed from this department.
Please list items and their amount needed from this department.
Please list items and their amount needed from this Department.
Please list the amount, brand if desired, and product description of items needed in a department not listed above..
Please list items and their amount needed from this department.
Please list items and their amount needed from this department.
Please list the amount, brand if desired, and product description of items needed from this department.
Please list the amount, brand if desired, and product description of items needed from this department.
LIQUOR & TOBACCO PRODUCTS
Birthdate
Birthdate
If you order Liquor or Tobacco Products, you must submit your birthdate.
Please list items and their amount needed from this department.
Please list the amount, brand, and product description of items needed from this department.
required agreements
Service Agreement *
Service Agreement required to submit order.
Liquor Delivery Agreement *
To receive an order containing alcoholic beverages, there must be an adult with proper ID to sign for the delivery.
Tobacco Product Delivery Agreement *
To receive an order containing tobacco products, there must be an adult with proper ID to sign for the delivery.