760 475-0612

 
 

 

Mountains of Groceries Order Form

Name

Name of Condo

Phone

Arrival Date and Time

Credit Card Number

Exp. Date

I would like organic when possible
 Yes 
 No 
We will substitute brands unless you say
 Yes 
 No 


Fruits and Vegetables:

Apples – Quantity and Brand Name if any

Bananas – Quantity and Brand Name if any

Cantaloupe – Quantity and Brand Name if any

Box of Clementines – Quantity and Brand Name if any

Grapefruit – Quantity and Brand Name if any

Grapes – Quantity and Brand Name if any

Lemons – Quantity and Brand Name if any

Limes – Quantity and Brand Name if any

Oranges – Quantity and Brand Name if any

Pears – Quantity and Brand Name if any

Strawberries- Quantity and Brand Name if any

Berries/Cherries – Quantity and Brand Name if any

Melon – Quantity and Brand Name if any

Misc Fruit – Quantity and Brand Name if any

Lettuce (specify) – Quantity and Brand Name if any

Salad Bag – Quantity and Brand Name if any

Salad Bag w/ Dressing – Quantity and Brand Name if any

Croutons – Quantity and Brand Name if any

Avocado) – Quantity and Brand Name if any

Bell Peppers – Quantity and Brand Name if any

Asparagus – Quantity and Brand Name if any

Broccoli – Quantity and Brand Name if any

Bag of Baby Carrots – Quantity and Brand Name if any

Celery – Quantity and Brand Name if any

Cucumber – Quantity and Brand Name if any

Garlic Bulbs – Quantity and Brand Name if any

Green Beans – Quantity and Brand Name if any

Mushrooms – Quantity and Brand Name if any

Onions – Quantity and Brand Name if any

Potatoes – Quantity and Brand Name if any

Tomatoes – Quantity and Brand Name if any

Cut Veg w/ dip Tray – Quantity and Brand Name if any

Tomatoes – Quantity and Brand Name if any


Dairy:

U Bake Cinnamon Rolls- Quantity and Brand Name if any

U Bake Toll House cookies – Quantity and Brand Name if any

A dozen of Eggs (size) – Quantity and Brand Name if any

Butter (Tub)- Quantity and Brand Name if any

Butter (1lb. box of sticks)- Quantity and Brand Name if any

Margarine – Quantity and Brand Name if any

Milk (specify %)- Quantity and Brand Name if any

Soy Milk- Quantity and Brand Name if any

Half & Half (pt or qt)- Quantity and Brand Name if any

Flavored Creamers – Quantity and Brand Name if any

Can of Whipped Cream – Quantity and Brand Name if any

Orange Juice – Quantity and Brand Name if any

Yogurt (specify flavor)- Quantity and Brand Name if any


Gourmet Cheese:

Block Cheese (specify)- Quantity and Brand Name if any

Shredded Cheese (specify) – Quantity and Brand Name if any

Kraft Singles – Quantity and Brand Name if any

Cottage Cheese – Quantity and Brand Name if any

Cream Cheese – Quantity and Brand Name if any

Sour Cream – Quantity and Brand Name if any

Block Cheese (specify)- Quantity and Brand Name if any

Gouda – Quantity and Brand Name if any

Brie – Quantity and Brand Name if any

Blue – Quantity and Brand Name if any

Feta – Quantity and Brand Name if any

Goat – Quantity and Brand Name if any

Parmesan – Quantity and Brand Name if any

Fresh Mozzarella – Quantity and Brand Name if any


Chips/Crackers:

Tortilla Chips – Quantity and Brand Name if any

Potato Chips – Quantity and Brand Name if any

Pretzels – Quantity and Brand Name if any

Pringles – Quantity and Brand Name if any

Microwave Popcorn- (Box of 3) – Quantity and Brand Name if any

Nuts (specify)- Quantity and Brand Name if any

Chip Dip – Quantity and Brand Name if any

Salsa (mild, med or hot)- Quantity and Brand Name if any

Crackers- Quantity and Brand Name if any

Cookies – Quantity and Brand Name if any

Chips Ahoy – Quantity and Brand Name if any

Oreos – Quantity and Brand Name if any


Smore Supplies for the fire pit:

Graham Crackers – Quantity and Brand Name if any

Big Marshmallows – Quantity and Brand Name if any

Hershey’s Choc-6 Pack – Quantity and Brand Name if any


Soda/Water:

Bottled Water-Case-16oz- Quantity and Brand Name if any

Bottled Water-Gallon jug – Quantity and Brand Name if any

Sparkling Water Bottles – Quantity and Brand Name if any

Soda – Quantity and Brand Name if any

Red Bull cans – Quantity and Brand Name if any

Gatorade-32 oz bottles – Quantity and Brand Name if any

Gatorade-8pk of 20 oz – Quantity and Brand Name if any


Bottled Juices:

Cranberry – Quantity and Brand Name if any

100% Cranberry Juice – Quantity and Brand Name if any

Apple – Quantity and Brand Name if any

Grape – Quantity and Brand Name if any

Misc Juice – Quantity and Brand Name if any


Canned Goods:

Canned Soup – Quantity and Brand Name if any

Chili – Quantity and Brand Name if any

Tomato Sauce – Quantity and Brand Name if any

Canned Tuna – Quantity and Brand Name if any

Canned Vegetables – Quantity and Brand Name if any

Canned Beans – Quantity and Brand Name if any

Canned Fruit – Quantity and Brand Name if any


Pasta:

Kraft Mac & Cheese – Quantity and Brand Name if any

Pasta (specify type) – Quantity and Brand Name if any

Spaghetti Sauce – Quantity and Brand Name if any

Parmesan Cheese – Quantity and Brand Name if any

Rice – Quantity and Brand Name if any


Condiments:

Ketchup – Quantity and Brand Name if any

Mustard – Quantity and Brand Name if any

Mayonnaise – Quantity and Brand Name if any

Salad Dressing (Specify) – Quantity and Brand Name if any

Pickles – Quantity and Brand Name if any

Olives – Quantity and Brand Name if any

Relish – Quantity and Brand Name if any

BBQ Sause – Quantity and Brand Name if any

Gravey – Quantity and Brand Name if any

Salsa – Quantity and Brand Name if any

S/P Combo – Quantity and Brand Name if any

Spice – Quantity and Brand Name if any

Olive Oil (16 oz is smallest) – Quantity and Brand Name if any

Other Oil (Specify) – Quantity and Brand Name if any

S/P Combo – Quantity and Brand Name if any

Sugar- Quantity and Brand Name if any


Breakfast:

Cereal – Quantity and Brand Name if any

Oatmeal – Quantity and Brand Name if any

Pancake Mix- Quantity and Brand Name if any

Syrup – Quantity and Brand Name if any

Syrup (100% Maple)- Quantity and Brand Name if any

Honey- Quantity and Brand Name if any

Jelly or Jam- Quantity and Brand Name if any

Peanut Butter (Specify Crunchy or Creamy)- Quantity and Brand Name if any

Coffee – Quantity and Brand Name if any

Coffee Filters – Quantity and Brand Name if any

Hot Cocoa (Box of pkts) – Quantity and Brand Name if any

Tea (Box of tea bags)- Quantity and Brand Name if any


Frozen Foods:

Waffles – Quantity and Brand Name if any

Pancakes – Quantity and Brand Name if any

Pizza – Quantity and Brand Name if any

Chicken Nuggets – Quantity and Brand Name if any

French Fries – Quantity and Brand Name if any

Tator Tots – Quantity and Brand Name if any

Lasagna – Quantity and Brand Name if any

TV Dinners – Quantity and Brand Name if any

Misc Frozen – Quantity and Brand Name if any

Ice Cream – Quantity and Brand Name if any

Ice Cream Novelties – Quantity and Brand Name if any

Popsicles – Quantity and Brand Name if any


Meats:

Steaks – Quantity and Brand Name if any

Chicken Breasts – Quantity and Brand Name if any

Ground Beef – Quantity and Brand Name if any

Ground Turkey – Quantity and Brand Name if any

Bacon – Quantity and Brand Name if any

Sausage Links/Patties – Quantity and Brand Name if any

Hot Dogs – Quantity and Brand Name if any

Rotissiere Chicken – Quantity and Brand Name if any

Pork Chops – Quantity and Brand Name if any

Frozen whole turkey – Quantity and Brand Name if any

Fish (Specify) – Quantity and Brand Name if any


If from Deli-specify lbs.:

Ham – Quantity and Brand Name if any

Turkey- Quantity and Brand Name if any

Salami – Quantity and Brand Name if any

Roast Beef – Quantity and Brand Name if any

Other – Quantity and Brand Name if any

Cheddar Cheese – Quantity and Brand Name if any

American Cheese – Quantity and Brand Name if any

Provolone Cheese – Quantity and Brand Name if any

Swiss Cheese – Quantity and Brand Name if any

Other – Quantity and Brand Name if any

Macaroni Salad – Quantity and Brand Name if any

Potato Salad – Quantity and Brand Name if any

Fried Chicken – Quantity and Brand Name if any

Tofu – Quantity and Brand Name if any


Breads:

White Bread – Quantity and Brand Name if any

Wheat Bread – Quantity and Brand Name if any

Rye Bread – Quantity and Brand Name if any

Italian Bread – Quantity and Brand Name if any

Fresh Garlic Bread – Quantity and Brand Name if any

Ready-bake breads – Quantity and Brand Name if any

Bagels-6 Pack – Quantity and Brand Name if any

Bagels-Individual – Quantity and Brand Name if any

English Muffins – Quantity and Brand Name if any

Hot Dog Buns – Quantity and Brand Name if any

Hamburger Buns – Quantity and Brand Name if any

Box of little Donuts – Quantity and Brand Name if any

Individual Bakery Donuts – Quantity and Brand Name if any

Muffins (Flavor) – Quantity and Brand Name if any


Miscellaneous Items:

Baby Food – Quantity and Brand Name if any

Diapers- (Size)- Quantity and Brand Name if any

Baby Wipes- Quantity and Brand Name if any

Deck of Playing Cards- Quantity and Brand Name if any

Disposable Camera – Quantity and Brand Name if any

Batteries – Quantity and Brand Name if any

Candy – Quantity and Brand Name if any

Paper Plates – Quantity and Brand Name if any

Plastic Silverware – Quantity and Brand Name if any

Plastic Cups – Quantity and Brand Name if any


Alcohol

Beer – Quantity and Brand Name if any

Club Soda / Tonic – Quantity and Brand Name if any

Champagne – Quantity and Brand Name if any

Gin – Quantity and Brand Name if any

Juice – Quantity and Brand Name if any

Mixer – Quantity and Brand Name if any

Red Wine / White Wine – Quantity and Brand Name if any

Rum – Quantity and Brand Name if any

Sake – Quantity and Brand Name if any

Whiskey- Quantity and Brand Name if any

Vodka – Quantity and Brand Name if any

Date of Birth

I acknowledge that THE GROCERY SHOPPER will not be held accountable for consumption of alcohol by minors under the age of 21. I certify that I am 21 years of age or older. I can and will provide picture identification to agent of THE GROCERY SHOPPER upon request.
 Agree 
 Do no agree 
Items not listed that you would like to purchase, comments or special instruction.

Email:
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