LEWES HOME DELIVERY

WELCOME TO THE LEWES HOME DELIVERY SIGN UP!

Please fill out the form below to sign up for our home delivery service beginning this Holiday Season! *

Yes, I am interested in home delivery.

How often would you be likely to utilize Home Delivery Services for your family? *

WEEKLY

BIWEEKLY

MONTHLY

OTHER OTHER

We are looking to offer insulated porch boxes for home delivery in your area. These would be large boxes able to hold six (6) gallons of milk and can easily fit an average order and maintain a cold hold of 2 hours without ice. This would be a one time purchase of $65. Would you be interested in purchasing a one-time charge porch box (this would be yours to keep after purchase)? *

Yes, I am interested in a porch box!

No, I am not interested in a porch box. I will provide my own cooler.

Additional Comments and Suggestions (Do you know of any local stores or businesses in the area that would possibly be interested in using/stocking our products?)

First Name *

Last Name *

Street Address *

Address Line 2 or Development Name

City *

State *

Zip Code *

Phone Number *

Email Address *