Coronacovery Delivery!

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Hello, thank you for your interest in our services! Please fill out the following information to get us started on your order.

THE (super simple) DELIVERY PROCESS:
1. Once you fill out the survey, we can calculate the total price and tell you an estimate time for your delivery.
2. After you have transferred the cost of your groceries/necessities to us, we will use it to purchase them for you.
3. We will deliver your items to your doorstep and notify you prior to arrival.
(*any remaining change will be returned to you along with the receipt)

Questions?
Text or call: (408) 667 - 9128
Email: coronacovery@gmail.com

Email *

Please note before continuing:

For the time being, our deliveries are restricted to only within Milpitas!

Name *

Phone number *

Do you have any allergies, specific food preferences, or preferred brands? *

I do not.

Other:

What would you like to order in your delivery? (Please specify quantity) *

How would you like to pay for your order? (Delivery is free) *

Electronic payment (Venmo, Apple, Paypal)

Physical cash after delivery

I would like to discuss further options with you.

When would you prefer this delivery? *

Wednesday from 3-7

Saturday from 3-7

Sunday from 3-7

What drop-off method would you prefer?

Please drop it off at my doorstep and wait for me to make sure I receive it.

Please just drop it off at my doorstep, I'll handle it from there!

Other:

Clear selection

How did you find us?

physical flyer

social media

suggestion by someone you know

Other:

Clear selection

Send me a copy of my responses.

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