115 Church St.
New Bedford, MA 02746
Voice: 508-999-1771
Fax: 508-997-8357

Store Hours

Monday - Friday

 8:00 am - 5:00 pm
Saturday 8:00 am - 1:00 pm

 

Customer Name:

______________________________________________________________
 

Phone:

________________________ * Required for call back confirmation-See below
 

Pickup Date:

________________________
 

Pickup Time:

________________________  

Quantity

Description

 Office Use

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Special instructions or notes

FAX & FILL -  it's easy!

  • Print this page.

  • Complete the form in its entirety and fax to 508-997-8157.

  • Please allow a minimum 2 hours between faxing and pick up.

  • A Maxi-Market Employee will telephone to acknowledge your order.

  • The Maxi-Market will have your order waiting for you!