Boston Delivers Information Form
Please fill out this form if you are interested in participating in the Boston Delivers program. After you fill out this form we will follow up with you and determine how your business can participate in Boston Delivers. If you wish to change any of the responses you provide after submitting the form, please email harper.mills@boston.gov

Your answers do not have to be exact, but please estimate the correct answers to the best of your ability. 

For more information on the Boston Delivers pilot program, please visit boston.gov/boston-delivers
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Business Contact Name *
What is the name of your business? *
What is your title or role in the business? *
What is the address of your business? *
Phone number *
Email address *
What type of business do you have? *
What forms of payment do you accept? *
Required
How do your customers place orders? *
Required
Is your business women and/or minority owned? (Please check all that apply) *
Required
Is your business/organization a non-profit? *
How many people does your business employ? *
Do you currently offer delivery? *
If you currently offer delivery, do you make your own deliveries or do you use a third party? If you use a third party/third parties – what do you use? (Examples of third parties include DoorDash, UberEats, Instacart, Shipt, another courier service, etc) *
On average how many deliveries do you deliver IN A WEEK? *
What kinds of vehicles are used to make the deliveries? (Please check all that apply) *
Required
Please estimate how many items/packages you would want delivered EACH WEEK using Boston Delivers *
What types of delivery would you want performed as a Boston Delivers participant? (Please check all that apply) *
Required
Boston Delivers couriers are able to travel UP TO 2 miles to make a delivery. Please check all towns/cities you anticipate delivering to using Boston Delivers.
How much do you typically pay per delivery? 
On average, what is the value of goods you deliver?
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Do you anticipate delivery of items that require any special handling?
Do you anticipate delivering perishable items?
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What is the weight of the packages you're delivering?
In order to study the impact of this program we will ask participating businesses to fill out up to 4 surveys about their experience using Boston Delivers. Would you be willing to fill out these surveys?
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Questions or comments?
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