Name
*
First Name
Last Name
Email
*
example@example.com
Do you want to receive a weekly email from us? (no more than 3 but mainly 1/week)
Phone number
*
Format: (000) 000-0000.
Jackpot Bundle
*
1 Bundle = $100
2 Bundles = $200
Pick Up or Delivery?
*
Friday Aug 28, 2026 8 am - 5 pm 1010 Ebenezer Rd Tompkinsville, KY 42167
Saturday Aug 29, 2026 8 am - 12 pm 1010 Ebenezer Rd Tompkinsville, KY 42167
Delivery $10 Burkesville, Glasgow, Edmonton, Columbia, Albany Monday August 31st, 2026
Delivery $10 Scottsville, Bowling Green, Lafayette, TN, Gallatin, TN Tuesday September 8th, 2026
Delivery $10 Tompkinsville, KY (within 2 miles of city limits) Aug 29, 2026
Delivery Customer ONLY By selecting Delivery, you will have your bundle plus delivery fee paid via this form or by phone with EBT by 8/28/26. I understand that if my order is not paid for by 8/28/26 then it will not be made.
I will pay using this form
I will call with my EBT card to pay the $100 and debit/credit card to pay the $10 fee.
Delivery Address ( If you choose your house and not a place of business, have a cooler big enough to pay the order on the porch)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
I will have a cooler out big enough for my order! Each order comes in a box about 12"x12"x12"
Yes
No
Special Directions for Delivery
Pay Here for the Bundle
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Jackpot Bundle
$100.00
$
100.00
Quantity
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Delivery Fee
$10.00
$
10.00
Quantity
1
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Credit Card
Submit
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