Delivery Customer Account Information

Mandatory *

First Name  * : Field not valid (required or bad value) Last Name  * : Field not valid (required or bad value) Phone Number : Field not valid (required or bad value) Email Address  * : Field not valid (required or bad value) Work Number : Field not valid (required or bad value) Cell Number : Field not valid (required or bad value) Postal Address  * : Field not valid (required or bad value) Credit Card # : Field not valid (required or bad value) Exp : Field not valid (required or bad value) Security Code : Field not valid (required or bad value) Pets : Pet #1 Name, Breed, Age Field not valid (required or bad value) Delivery Address  * : Field not valid (required or bad value) Directions (main cross streets, new area, gate or driveway entrance) : Field not valid (required or bad value) Special Instructions (where should items be left, gate codes, beware of dog, etc.) : Field not valid (required or bad value) I will be ordering fresh frozen pet food and will require cooler service : Field not valid (required or bad value) I have read and understand Dexter’s Deli Delivery Policies : Field not valid (required or bad value) I want to be set-up on auto-delivery. Dexter’s Deli will contact me with the details : Field not valid (required or bad value)