Delivery Service

The average monthly delivery service is as low as $21.98. This price includes: two 5 gallon bottles each month with the option of a dispenser


Please complete the form below to sign up for delivery service. 

Date *
Date
Name *
Name
Delivery Address *
Delivery Address
PLEASE MAKE SURE ALL IMFORMATION HERE IS CORRECT.
Phone *
Phone
Water Service: Size, Type & Price
The amount of 5 gallon bottles you want for delivery at $6.99 a bottle
$7.99 a bottle
The amount of 3 gallon bottles you want for delivery at $5.99 a bottle
$6.99 a bottle
Water Cooler
Rent a Cooler *
If you want a cooler included with your delivery, please check what options apply
8.00 per month for cooler rental
Delivery Prefrences
Area of Delivery *
Time *
Choose either Bi-weekly or a Once a month delivery
Please note down any special delivery instructions you have in the text area below
Payment Information
Automatic Payment
Select yes or no
Name (as appears on card) *
Name (as appears on card)
Billing Address *
Billing Address
Type of Card *
example 10/11
3 digit code
OPTIONAL
TERMS:
No contracts. Month to month basis until terminated in accordance with this agreement
Option to skip delivery
If product is not required you must contact Customer Service prior to your regularly scheduled route day to request a 'skip' for applicable date(s) of service
PLEASE NOTE THAT WATER WATER TO GO POLICY REQUIRES OUR ROUTE REPRESENTATIVE TO DELIVER THE PRODUCT MINIMUM ONCE THEY ARRIVE AT THE SERVICE ADDRESS