delivery form pop up - Beverly Corners

DELIVERY

Fields marked with an * are required

First Name*

Last Name*

Email*

Data of Birth*

RewardsPal Card #

23 of 23 Character(s) left

Mobile Phone*

10 of 10

May we Contact you?*

Home Phone

12 of 12 Character(s) left

Address *

City *

Province *

Country *

Postal Code *

7 of 7 Character(s) left

Date of Delivery *

Preferred Delivery Time *

Budweiser, Yellow Tail Shiraz...
Item #1*

750 ml, 2 L, 6 Cans...
Item #1 Size*

1, 2, 3, 4...10 etc .
Item #1 Quantity*

Item #2

Item #2 Size

Item #2 Quantity

Item #3

Item #3 Size

Item #3 Quantity

Item #4

Item #4 Size

Item #4 Quantity

Item #5

Item #5 Size

Item #5 Quantity

Item #6

Item #6 Size

Item #6 Quantity

Item #7

Item #7 Size

Item #7 Quantity

Item #8

Item #8 Size

Item #8 Quantity

Item #9

Item #9 Size

Item #9 Quantity

Item #10

Item #10 Size

Item #10 Quantity

Delivery Instructions

*If you have more than 10 items, please submit another order form and mention in the box below that you will be continuing the order.

If ordering for more than 1 person, please submit each order individually.

I confirm the person ordering and receiving this order is 19+ years of age

*They must have 2 valid pieces of ID (1 gov't issued photo ID, and 1 other valid ID with name and signature), and if applicable show the valid credit card used as payment (will be verified to match ID)

A Beverly Corners Liquor Store member will contact me via telephone to confirm the order and process my credit card

*Please note that due to heavy volume of orders at this time, we may take up to 48 hours to get back to you. We appreciate your patience

Product substitutions may be necessary

*A team member will check with me first by phone

I understand my order will be delivered to my doorstop only

*Under no circumstances will a team member go inside my house

I have not been outside the country in the last 14 days, and am not showing symptoms of illness of any kind

*We are unable to deliver to customers under quarantine

COME VISIT US

Open 9am - 11pm Daily

COME VISIT US

Open 9am - 11pm Daily

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