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Fridley Liquor Order Form

2. Please complete the form below to place an online order. Once submitted, a member of the Fridley Liquor team will contact you to process your payment information.

   Please complete the form below to place an online order. Once submitted, a member of the Fridley Liquor team will contact you to process your payment information.

4. Be as descriptive as possible when indicating the item(s) you would like. For example: Item = Bud Light, Size = 24 pack, Quantity = 1 Item = Titos Vodka, Size = 1.7 liter, Quantity = 2. You can also reference our inventory list linked right below.

   Be as descriptive as possible when indicating the item(s) you would like. For example: Item = Bud Light, Size = 24 pack, Quantity = 1 Item = Titos Vodka, Size = 1.7 liter, Quantity = 2. You can also reference our inventory list linked right below.

6. Inventory List
   Fridley Liquor Inventory

   If you are viewing the inventory PDF on a desktop you can find specific product by doing the following: On Windows: CTRL+F then start typing the product you're looking for. On Mac: Command+F then start typing the product you're looking for.

8. First Name*

9. Last Name*

11. Phone Number*

12. Email Address

14. Rewards Card Number

    located on the back of your card.

16. 

18. Preferred Pick-Up Date*
    Preferred Pick-Up Date

19. Preferred Pick-Up Time*
    -- Select One --12:00 p.m.12:30 p.m.1:00 p.m.1:30 p.m.2:00 p.m.2:30 p.m.3:00 p.m.3:30 p.m.4:00 p.m.4:30 p.m.5:00 p.m.5:30 p.m.6:00 p.m.6:30 p.m.7:00 p.m.7:30 p.m.

21. Item

22. Size

23. Quantity
    -- Select One --12345678910+

25. Item

26. Size

27. Quantity
    -- Select One --12345678910+

29. Item

30. Size

31. Quantity
    -- Select One --12345678910+

33. Item

34. Size

35. Quantity
    -- Select One --12345678910+

37. Item

38. Size

39. Quantity
    -- Select One --12345678910+

41. Item

42. Size

43. Quantity
    -- Select One --12345678910+

45. Item

46. Size

47. Quantity
    -- Select One --12345678910+

49. Item

50. Size

51. Quantity
    -- Select One --12345678910+

53. Item

54. Size

55. Quantity
    -- Select One --12345678910+

57. Item

58. Size

59. Quantity
    -- Select One --12345678910+

Leave This Blank:


61. 1. Receive an email copy of this form.
62. Email address

    This field is not part of the form submission.

63. Submit

* indicates a required field