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180 Smoke Ritson Online Order
Curbside Pick Up Online Order Form
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First name:
*
Your answer
Last Name:
*
Your answer
Email Address:
*
Your answer
Phone Number:
*
Your answer
Are you a loyalty member? If yes, please enter the number on the back of your card in the 'other' section
*
No
Other:
Are you over 19? ID required for pick up *
*
Yes
No
What items are you looking for today? Please specify nic. strength and coil selections
*
Your answer
Please enter credit card information including number, expiry, cvv and the name as indicated on the card. Note that we will not keep the information after the transaction has been completed. You may also pay at store upon pickup or by etransfer.
Your answer
What day would you like to pick it up?
*
MM
/
DD
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YYYY
What time would you like to pick up?
*
12:30
1:00
1:30
2:00
2:30
3:00
3:30
4:00
4:30
5:00
5:30
6:00
6:30
Would you like confirmations by phone or email?
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