Telluride Delivery Order Form

Please add in all items and be as specific as possible about what you want to have delivered.

* Your Full Name

* Email

Produce, Fresh Fruits & Vegetables (You may add items at the end of this form)

Quantity

Size

Description

Dairy Products

Quantity

 

Size

Description

Milk

Cream

Yogurt

Cheese

Eggs

Butter/Margarine

Other

Meats, Poultry, Fish and Seafood

Quantity

 

Size

Description

NY Steak

Sirloin Steak

T Bone Steak

Roast

Pork

Ham

Bacon

Ground Beef

Sausage

Lunch Meat

Hot Dogs

Chicken

Turkey

Pate

Salmon

Trout

Tuna

Lobster

Crab

Shrimp

Other

Other

General Miscellaneous

Quantity

 

Size

Description

Cereal

Pancake Mix

Syrup

Sugar

Honey

Peanut Butter

Jelly

Salad Dressing

Catsup

Mustard

Mayonaise

Spices

Canned Foods

Cookies

Crackers

Chips

Bread

Buns

Pasta

Other

Other

Frozen and Microwave Foods

Quantity

 

Size

Description

Ice Cream

Frozen Yogurt

Berries

Pizza

Waffles

Other

Other

Beverages

Quantity

 

Size

Description

Juices

Water

Soda

Soda

Coffee

Tea

Other

Other

Wine

Quantity

 

Size

Brand

Red

White

Rosé

Champagne

Liquor

Quantity

 

Size

Brand

Bourbon

Gin

Scotch

Rum

Cognac

Tequilla

Vodka

Brandy

Other

Other

Beer

Quantity

 

Size

Brand

Domestic

Imported

Guest Information

* Hotel, Condominium, or Address:

Phone Number in Telluride (If known):

* Reservation Agency:

* Guest Name:

* Billing Address:

* City:

* State:

* Zip:

* Phone Number - Your Cell:

Date & Time of Arrival:

* Date & Time To Deliver:

* I authorize Telluride Delivery to receive payment for services rendered using the following option:

I would like to tip the delivery person Other $:

* Initials (Required for Web Submission):

"By Signing/Initialing above I am authorizing charges to my credit card, and I am affirming that the recipient(s) of any alcoholic beverages are 21 years of age or older. I understand that Telluride Delivery will not be held responsible for any mishandling of alcohol by minors".

Driver's License # (If Purchasing Alcohol):

D.O.B:

Credit Card Information

* Name as it appears on card:

* Type of Card:

* Credit Card text:

* Expiration Date:

Month: Year:

* CVV text (Security Code):

Special Instructions, Additional Items, etc:

We recommend you print this page for your records before submitting!