Grocery Order Form Name First Last PhoneMember Number Date you wish to pick up your order MM slash DD slash YYYY Time you wish to pick up your order : Hours Minutes AM PM AM/PM MeatsGround Beef 81/19 Price: $3.99 Quantity: Price per lbAngus Ground Beef Price: $6.99 Quantity: Price per lb6 oz Certified Angus Beef Tenderloin Price: $12.00 Quantity: Price per each16 oz Certified Angus Beef Ribeye Price: $18.00 Quantity: Price per eachSliced Bacon Price: $4.99 Quantity: Price per lbBreakfast Sausage Patty Price: $4.99 Quantity: Price per lbItalian Sausage Price: $4.25 Quantity: Price per lbHot Dogs 6/1 Price: $3.75 Quantity: Price per lbEggs Price: $0.35 Quantity: Price per eachChicken Breast Filets Price: $4.25 Quantity: Price per lbCenter Cut Pork Loin Chops Price: $3.59 Quantity: Price per lbDairySliced American Price: $3.99 Quantity: Price per lbSliced Cheddar Price: $4.50 Quantity: Price per lbShredded Cheddar Price: $5.50 Quantity: Price per lbShredded Mozzarella Price: $4.10 Quantity: Price per lbMilk Price: $4.50 Quantity: Price per gallonProduceIQF Green Beans Price: $3.34 Quantity: Price per lbBroccoli Price: $2.49 Quantity: Price per lbZuchinni Price: $1.99 Quantity: Price per lbAsparagus Price: $4.50 Quantity: Price per lbTomatoes Price: $0.75 Quantity: Price per lbBaking Potatoes Price: $0.99 Quantity: Price per lbOnions Price: $0.99 Quantity: Price per lbLimes Price: $0.50 Quantity: Price per lb English Cucumber Price: $2.00 Quantity: Price per eachLemons Price: $0.50 Quantity: Price per eachOranges Price: $0.99 Quantity: Price per eachBananas Price: $0.79 Quantity: Price per lbOther FoodsFrench Fries Price: $2.00 Quantity: Price per lbSpaghetti Noodles Price: $1.50 Quantity: Price per lbPenne Pasta Price: $1.99 Quantity: Price per lbRigatoni Price: $1.99 Quantity: Price per lbFlour Price: $0.60 Quantity: Price per lbSugar Price: $0.99 Quantity: Price per lbMarinara Sauce Price: $2.99 Quantity: Price per qtChicken Soup 7.25oz Price: $1.49 Quantity: Price per canPeanut Butter Price: $0.30 Quantity: Price per ozSliced White Bread Price: $5.50 Quantity: Price per loafSliced Wheat Bread Price: $5.49 Quantity: Price per loafHamburger Bun Price: $0.50 Quantity: Price per eachHot Dog Buns Price: $0.40 Quantity: Price per eachHoagie Rolls Price: $0.90 Quantity: Price per eachDeli MeatsSliced Ham Price: $4.99 Quantity: Price per lbSliced Turkey Price: $5.05 Quantity: Price per lbSliced Salami Price: $6.00 Quantity: Price per lbSliced Pepperoni Price: $5.25 Quantity: Price per lbSeafoodIQF Barramundi Filet Skin On 6-8oz Price: $5.00 Quantity: Price per eachIQF Sea Bass Branzino 6-8oz Filet Price: $5.00 Quantity: Price per eachIQF Flounder Filet 6-8oz Price: $5.00 Quantity: Price per eachShrimp Price: $9.99 Quantity: Price per lbAlcoholBud Light Price: $12.00 Quantity: 6 Pack - BottlesCoors Light Price: $12.00 Quantity: 6 Pack - BottlesMiller Light Price: $12.00 Quantity: 6 Pack - BottlesMichelob Ultra Price: $14.00 Quantity: 6 Pack - BottlesCanyon Roads Cabernet Price: $12.00 Quantity: Wine BottleCanyon Roads Merlot Price: $12.00 Quantity: Wine BottleCanyon Roads Pinot Noir Price: $12.00 Quantity: Wine BottleCanyon Roads Chard Price: $12.00 Quantity: Wine BottleCanyon Roads Pinot Grigio Price: $12.00 Quantity: Wine BottleMiscellaneousToilet Tissue Price: $1.25 Quantity: Price per rollPaper Towel Price: $2.00 Quantity: Price per rollBox of 100 Disposal Gloves Price: $22.00 Quantity: Total $0.00