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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.
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.
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