Curbside Pick-Up Form

Email your order to sales@middleburyagway.com – we will confirm receipt and call you with your pick up time and to receive your payment information.

Customer's Name:

Customer's Cell Phone Number:

Customer's Email Address:

Requested Pick-Up Date:

Requested Pick-Up Time:

1. Description of Item and SKU# from our Website when Possible:

1. Quantity:

2. Description of Item and SKU# from our Website when Possible:

2. Quantity:

3. Description of Item and SKU# from our Website when Possible:

3. Quantity:

4. Description of Item and SKU# from our Website when Possible:

4. Quantity:

5. Description of Item and SKU# from our Website when Possible:

5. Quantity:

Additional inquiries or products you would like to add:

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