New Customer Order Form


Please fill out the online order form below and click the submit button when it is complete. Your order will be processed the next business day if Urban Organic receives it by 3PM. Please feel free to call us at (718) 499-4321 Monday - Friday from 9am-5pm, or email us at: info@urbanorganic.com*** THIS IS NOT THE FORM TO REGISTER TO OUR WEBSITE. TO REGISTER TO THIS SITE PLEASE CLICK HERE. NOTE:*** Upon signing up you are agreeing to receive deliveries from us every week. The contents of the box change week to week and all items are subject to change due to availability and quality. See this week's produce list for details.*** All areas with a $4.99 delivery fee and higher MUST begin with a Original Value Box ($34.99 Box). See our Delivery Schedule for details.*** If you want a delivery every two weeks or if you want us to deliver to you on a periodic basis you MUST let us know by saying so in the comments section below. For Brooklyn and Manhattan customers that is also where you specify if you would prefer a time window of 2pm-6pm or 6pm-10:30pm. All other areas receive delivery between the hours of 2pm and 10:30pm, we CANNOT provide a smaller window for outer areas.*** Items in our Juice Box are subject to change without notice and are available on a seasonal basis.*** THERE IS A $25 ONETIME LIFETIME REGISTRATION FEE FOR ALL NEW CUSTOMERS. THE REGISTRATION FEE IS APPLIED TO YOUR FIRST DELIVERY AND IS NON-REFUNDABLE.(All Groupon Customers will have this $25.00 Registration fee waived.) ALL FIELDS MARKED WITH AN ASTERISK (*) ARE REQUIRED.

Please enter your first name.

Please enter your last name (surname).

Please enter your preferred email address.

Please enter your street address for deliveries.

Enter your floor or apartment number, if applicable.

Good directions are key to making sure we get your order to you! Please provide the streets your block is between, for example 1st Avenue between West 6 Street and West 7 Street.

Enter the other cross street for your block.

Enter any special instructions, if needed.

Choose your city.

Choose your state.

Enter your zip code.

Enter your mobile/ daytime phone number.

Enter your evening phone number.

If you are not home, what do we do with your delivery? We CANNOT take the box back, redeliver the next day, or call you upon arrival, so please be specific. Mailing a key to your entryway door is an option for our customers. If you will be mailing a key please call our office for more detailed instructions. (You MUST leave if not home instructions if you do not we will enter our own policy to leave it by your door.)

Please tell us how you heard about Urban Organic.
(GROUPON CUSTOMERS, PLEASE SAY "GROUPON NYC", "GROUPON WESTCHESTER", ETC.)

To see this week's produce list click here. For more inofrmation on our boxes click here.
(GROUPON CUSTOMERS MUST CHOOSE OUR $34.99 ORIGINAL VALUE BOX)

You can select up to 3 items which you NEVER want in your box. We will substitute another item from the current week's produce list, a fruit for a fruit and a vegetable for a vegetable. Please keep in mind that this pertains to all fruits and vegetables, NOT our grocery items.

You may choose up to 3 items of produce which you NEVER want in your box.

You may choose up to 3 items of produce which you NEVER want in your box.

CREDIT CARD INFORMATION IS REQUIRED

Enter a valid credit card number.
***GROUPON CUSTOMERS MAY ENTER A '0'***

***GROUPON CUSTOMERS MUST ENTER THEIR 10-14 DIGIT GROUPON CODE NUMBER***

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Urban Organic - Save Money, Save Time, Save the Planet!


Office Hours: Monday through Friday, 9:00 AM - 5:00 PM
E-mail: info@urbanorganic.com
Address: 240 Sixth Street, Brooklyn, NY 11215
Phone: (718) 499-4321 Fax: (718) 965-4688