Jekyll Market - On-Island Delivery Order Form
Print and Email to JekyllMarket@gmail.com
Jekyll Market Grocery Order Form 
Name: ___________________________________________ 
Delivery Address: __________________________________ ________________________________________________ 
Tel _____________________ Del Time: ________________ 
Credit Card: ______________________________________ 
Expiration: __________ Code: _______________________ 

Fresh Fruits & Vegetables:
  __ Apples (Red or Green) Qty: _______ 
__ Oranges Qty: _______ 
__ Bananas Qty: _______ 
__ Grapes (Green or Red) Qty: _______ 
__ Strawberries Qty: _______ 
__ Lemon or Lime Qty: _______ 
__ Lettuce Qty: _______ 
__ Cucumber Qty: _______ 
__ Tomatoes Qty: _______ 
__ Bell Pepper Qty: _______ 
__ Carrots Qty: _______ 
__ Celery Qty: _______ 
__ Avocado Qty: _______
 __ Potatoes (Idaho or Red) Qty: _______
 __ Sweet Potato Qty: _______ 
__ Other Qty: _______ _______________________________________________ 

Dairy:  
__ Milk (Skim,2%, Whole) Qty: _______ 
__ Half ‘n Half or Heavy Cream Qty: _______
 __ Cream Cheese Qty: _______ 
__ Sour Cream Qty: _______ 
__ Eggs Qty: _______ 
__ Butter or Margarine Qty: _______ 
__ Yogurt Qty: _______
 __ Shredded Cheese Qty: _______ 
__ Other Qty: _______ _______________________________________________ 

Deli:  
__ Sliced Meat Qty: _______ 
__ Sliced Cheese Qty: _______ 
__ Prepared Salads Qty: _______ 

Pick Meats: __Ham __ Turkey __ Chicken __ Salsalito Turkey __ Buffalo Chicken __Curried Chicken __ London Broil __ Corned Beef __ Pastrami __ Pepperoni __ Capicola __ Genoa Salami  

Pick Salads: __ Tuna Salad __ Shrimp Salad __ Chicken Salad - Homestyle or Pesto __ Pimento Cheese (Reg or Jalapeno) __ Lobster Sensation  

Pick Cheeses: __ Cheddar __ Swiss __ Provolone __ Mozzarella __ American __ Parmesan __ Havarti __ Pepper Jack __ Smoked Gouda __ Other Qty: _______ ________________________________________________ 

Bakery:  
__ Bread Qty: _______ 
__ Hotdog or Hamburger Buns Qty: _______
 __ Bagels Qty: _______ 
__ Muffins Qty: _______ 
__ Cookies Qty: _______ 
__ Crackers Qty: _______ 
__ Other Qty: _______ ________________________________________________ 

Meat/Seafood:  
__ Ground Beef Qty: _______
 __ Filet Mignon Qty: _______
 __ Ribeye Qty: _______ 
__ Chicken Breast Qty: _______ 
__ Wild Georgia Shrimp Qty: _______
 __ Bacon Qty: _______
 __ Sausage Qty: _______
 __ Frozen Fish (Cod or Salmon) Qty: _______
 __ Other Qty: _______ ________________________________________________ 

Frozen Foods:  
__ Vegetables Qty: _______ 
__ Pizza Qty: _______ 
__ Ice Cream Qty: _______
 __ Other Qty: _______ ________________________________________________ 

Snacks:
  __ Granola Bars Qty: _______
 __ Raisins Qty: _______ 
__ Apple Sauce Qty: _______ 
__ Pop Corn Qty: _______ 
__ Other Qty: _______ ________________________________________________ 

Spices/Condiments/Baking:
  __ Other Qty: _______
 ________________________________________________ ________________________________________________ 

Drinks/Beverages:  
__ Bottled Water (24 pk) Qty: ________
 __ Other Qty: _______ 
________________________________________________ ________________________________________________ 

Canned/Dry Items:
  __ Other Qty: _______ 
________________________________________________ ________________________________________________ 

Supplies:  __ Other Qty: _______
 ________________________________________________ ________________________________________________ 

Toiletries  __ Other Qty: _______ 
________________________________________________ ________________________________________________ 

Miscellaneous 
________________________________________________ __ Other Qty: _______ ________________________________________________ ________________________________________________ __ Other Qty: _______ ________________________________________________ ________________________________________________ __ Other Qty: _______ ________________________________________________ ________________________________________________ __ Other Qty: _______ ________________________________________________ ________________________________________________ __ Other Qty: _______ ________________________________________________ ________________________________________________ __ Other Qty: _______ ________________________________________________ ________________________________________________ __ Other Qty: _______ ________________________________________________ ________________________________________________ __ Other Qty: _______ ________________________________________________ ________________________________________________ __ Other Qty: _______ 
________________________________________________ ________________________________________________ __ Other Qty: _______ ________________________________________________ ________________________________________________ __ Other Qty: _______ ________________________________________________ ________________________________________________ __ Other Qty: _______ 

Please note that w e will endeavor to fill you order as close as possible. Note that there are shortages currently of toilet paper, bleach, antibacterial wipes, milk, bread, paper towels, and other sundries. Please be as specific as possible if you want a particular brand. If it is not available, please note if you will not accept a substitute. For example, if you only like Hellman’s mayonnaise, let us know if you will not accept another brand.  

There is a $10 delivery fee for Jekyll Island residents and a $75 minimum order . We will box groceries and leave for you on the porch or covered entryway. Someone must be home to receive the order, but personal contact is not necessary. Your credit or debit card will be charged prior to delivery. No cash accepted by drivers. Call in orders are not accepted due to high volume of store traffic. Print a copy and snap a picture of your order with your phone and email to jekyllmarket@gmail.com