Department Store Delivery Form

Department Store Delivery Form

Please complete all fields accurately to ensure prompt and correct delivery.

Customer Name

    Phone number

      Email

        Address

          Type of Delivery

          • Standard

          • Express

          Preferred Delivery Date & Time

            Package Details

            Is the package fragile?

            • Yes

            • No

            Special Delivery Instructions

            Return Option

            • Yes, include a return label

            • No return label needed

            Insurance Option

            • Yes

            • No

            Name:

            Date:

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