2. Instructions
   Please visit your prefered store, create an account, fill your cart, schedule a pick-up, and pay for your order. IMPORTANT: Be sure to select a date no less than 2 days in the future from order date to allow time for volunteers to plan.
4. Cash Wise
   Cash Wise
5. Walmart
   Walmart Grocery
6. Delivery Locations
   Limited volunteers are available to deliver to the following locations outside of Minot: • Burlington • Velva • Surrey • Sawyer, • Minot Air Force Base • Des Lacs • Glenburn • Lansford
8. After Order
   After you have completed your order please provide the following details.
10. Pick-up Location*

    Which store did you use?

    1. Cashwise
    2. Walmart Grocery
11. Date of pick-up*
    Date of pick-up

    Date of pick-up
12. Pick-up Name*
    Who's name is the order under?
13. Text or Email Alert*

    Would you like text or email alert when your groceries arrive?

    1. No
    2. Text
    3. Email
    4. Either
15. Name*
16. Email Address*
18. Address*
20. City*
21. State
22. Zip Code*
24. Phone Number*
25. Alternative Number
27. Delivery Instructions
    A dispatcher for our program will contact a volunteer who will be available to pick up your grocery items and deliver them to you. The volunteer will leave them outside your front door and knock or ring your doorbell to let you know they are there. The volunteer will not stay any longer than is necessary.
Leave This Blank:


29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit

* indicates a required field