Door Step Delivery of Milk

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Please help us out with some more information.
Following the amazing response from our last survey, we are now looking to build a better idea of what exactly you would like and how often. This is NOT an order but it will give us an idea of what quantities etc we need to be looking at and minimise wastage etc. Thank you for supplying your feedback we can assure you that any data you provide us with will only be used by our business and not supplied to any other.

Our Target area is KW1 & KW3 Post code areas in the first instance - however if you are out with these areas please still take part as we will be looking to expand into these areas soon.

Name *

Email *

Address *

postcode *

Phone number *

What product do you require? *

Whole Milk (pint - 85p)

Whole Milk (2pt -£1.60)

Whole Milk (2litre - £2.80)

Semi-skimmed Milk (pint - 85p)

Semi-skimmed Milk (2pt -£1.60)

Semi-Skimmed milk (2l - £2.80)

Skimmed Milk (pint - 85p)

Skimmed Milk (2pt - £1.60)

Skimmed Milk (2litre - £2.80)

Gold Top Milk (pint - £1)

Gold Top Milk (2pt - £1.90)

Gold Top Milk (2 litre- £3.00)

Required

How often would you like delivery? *

Daily

Every other day/three times a week (M/W/F)

Twice a week (T/Th)

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms