FAX
Customer Company Name ____________________________ Name _____________________________ Pick-up Time: ____________ (allow 20 min.)
(Darken circle next to your choices)
Phone: ____________________
CHIPS ON SALAD? 6” corn (taco) Fish* Hot Salsa 8 oz
Name: _____________________
CIRCLE YOUR CHOICES
BURRITO
12” flour Steak Black Beans Onions
on side)
SALAD
TACO (# tacos_______)
12” spinach Cheese Jalapenos 12” chipotle
COMBO?
CHIPS ONLY?
Choose Tortilla: Choose Type: Choose Freebies: Choose Extras:
10” flour Chicken Rice Cilantro
12” wheat Lettuce Cucumbers
6“ flour (taco) Beans & Rice
Chicken Chipotle Pintos Beans Black Olives
Veggies (peppers, onions, mushrooms) Pico de Gallo Sour Cream
Mild Salsa Tomatoes Queso:
on side)
Green Salsa Green Onions 2 oz 4 oz
Guacamole (
Peppers & Onions (
on side)
Garlic Mushrooms (
Choose Salad Dressings:
Nan’s Ranch
Chipotle Honey Mustard
Tomatillo Vinaigrette COMBO? CHIPS ONLY? CHIPS ON SALAD? 6” corn (taco) Fish* Hot Salsa 8 oz
Name: _____________________
CIRCLE YOUR CHOICES
BURRITO
12” flour Steak Black Beans Onions
on side)
SALAD
TACO (# tacos_______)
12” spinach Cheese Jalapenos 12” chipotle
Choose Tortilla: Choose Type: Choose Freebies: Choose Extras:
10” flour Chicken Rice Cilantro
12” wheat Lettuce Cucumbers
6“ flour (taco) Beans & Rice
Chicken Chipotle Pintos Beans Black Olives
Veggies (peppers, onions, mushrooms) Pico de Gallo Sour Cream
Mild Salsa Tomatoes Queso:
on side)
Green Salsa Green Onions 2 oz 4 oz
Guacamole (
Peppers & Onions (
on side)
Garlic Mushrooms (
Choose Salad Dressings:
Nan’s Ranch
Chipotle Honey Mustard
Tomatillo Vinaigrette COMBO? CHIPS ONLY? CHIPS ON SALAD? 6” corn (taco) Fish* Hot Salsa 8 oz
Name: _____________________
CIRCLE YOUR CHOICES
BURRITO
12” flour Steak Black Beans Onions
on side)
SALAD
TACO (# tacos_______)
12” spinach Cheese Jalapenos 12” chipotle
Choose Tortilla: Choose Type: Choose Freebies: Choose Extras:
10” flour Chicken Rice Cilantro
12” wheat Lettuce Cucumbers
6“ flour (taco) Beans & Rice
Chicken Chipotle Pintos Beans Black Olives
Veggies (peppers, onions, mushrooms) Pico de Gallo Sour Cream
Mild Salsa Tomatoes Queso:
on side)
Green Salsa Green Onions 2 oz 4 oz
Guacamole (
Peppers & Onions (
on side)
Garlic Mushrooms (
Choose Salad Dressings:
Nan’s Ranch
Chipotle Honey Mustard
Tomatillo Vinaigrette COMBO? CHIPS ONLY? CHIPS ON SALAD? 6” corn (taco) Fish* Hot Salsa 8 oz
Name: _____________________
CIRCLE YOUR CHOICES
BURRITO
12” flour Steak Black Beans Onions
on side)
SALAD
TACO (# tacos_______)
12” spinach Cheese Jalapenos 12” chipotle
Choose Tortilla: Choose Type: Choose Freebies: Choose Extras:
10” flour Chicken Rice Cilantro
12” wheat Lettuce Cucumbers
6“ flour (taco) Beans & Rice
Chicken Chipotle Pintos Beans Black Olives
Veggies (peppers, onions, mushrooms) Pico de Gallo Sour Cream
Mild Salsa Tomatoes Queso:
on side)
Green Salsa Green Onions 2 oz 4 oz
Guacamole (
Peppers & Onions (
on side)
Garlic Mushrooms (
Choose Salad Dressings:
Nan’s Ranch
Chipotle Honey Mustard
Tomatillo Vinaigrette COMBO? CHIPS ONLY? CHIPS ON SALAD? 6” corn (taco) Fish* Hot Salsa 8 oz
Name: _____________________
CIRCLE YOUR CHOICES
BURRITO
12” flour Steak Black Beans Onions
on side)
SALAD
TACO (# tacos_______)
12” spinach Cheese Jalapenos 12” chipotle
Choose Tortilla: Choose Type: Choose Freebies: Choose Extras:
10” flour Chicken Rice Cilantro
12” wheat Lettuce Cucumbers
Chicken Chipotle Pintos Beans Black Olives
Veggies (peppers, onions, mushrooms) Pico de Gallo Sour Cream
6“ flour (taco) Beans & Rice
Mild Salsa Tomatoes Queso:
on side)
Green Salsa Green Onions 2 oz 4 oz
Guacamole (
Peppers & Onions (
on side)
Garlic Mushrooms (
Choose Salad Dressings:
Nan’s Ranch
Chipotle Honey Mustard
Tomatillo Vinaigrette COMBO? CHIPS ONLY? CHIPS ON SALAD? 6” corn (taco) Fish* Hot Salsa 8 oz
Name: _____________________
CIRCLE YOUR CHOICES
BURRITO
12” flour Steak Black Beans Onions
on side)
SALAD
TACO (# tacos_______)
12” spinach Cheese Jalapenos 12” chipotle
Choose Tortilla: Choose Type: Choose Freebies: Choose Extras:
10” flour Chicken Rice Cilantro
12” wheat Lettuce Cucumbers
6“ flour (taco) Beans & Rice
Chicken Chipotle Pintos Beans Black Olives
Veggies (peppers, onions, mushrooms) Pico de Gallo Sour Cream
Mild Salsa Tomatoes Queso:
on side)
Green Salsa Green Onions 2 oz 4 oz
Guacamole (
Peppers & Onions (
on side)
Garlic Mushrooms (
Choose Salad Dressings:
Nan’s Ranch
Chipotle Honey Mustard
Tomatillo Vinaigrette 12/08
*Fish tacos are made on corn tortillas with cilantro, onions, white sauce, cabbage and mild salsa.
Give us a call to cater your next event!
Call about franchise information. Blue Coast Burrito PO Box 1128, Brentwood, TN 37024-1128 877-873-9090 www.bluecoastburrito.com