FIRESIDE MEAL REQUEST FORM
BREAKFAST LUNCH DINNER
COST PER PERSON (*) $10.50 $11.75 $14.75
(*) MINIMUM CHARGE FOR ANY GROUP – IS FOR 25 PERSONS
(*) NO SPLIT COOKING - YOU PREPARE ALL MEALS DURING YOUR STAY AT THE FIRESIDE RETREAT CENTER
(OR) OUR STAFF AT FIRESIDE PREPARES ALL THE MEALS
DATE REQUESTING MEAL (DRM) NUMBER OF MEALS (NOM) TIMES (X) COST PER MEAL (CPM) = TOTAL (T$)
BREAKFAST (**) 8:00 AM BREAKFAST MEALS SERVED WITH CHOICE OF ORANGE JUICE, COFFEE, TEA, MILK
DRM NOM X CP M = T$__
______ (1) HASHBROWNS, SCRAMBLED EGGS WITH DICED HAM, FRUIT, MUFFINS _____ _____ _____
_______(2) PANCKAES, SCRAMBLED EGGS WITH DICED HAM, FRUIT _____ _____ _____
_______(3) GRILLED FRENCH TOAST, SCRAMBLED EGGS WITH DICED HAM, FRUIT _____ _____ _____
_______(4) PANCAKES, FRESH FRUIT SYRUP W/WHIP CREAM, FRUIT BACON _____ _____ _____
_______(5) BAKED STUFFED FRENCH TOAST, BACON, FRUIT _____ _____ _____
_______(6) QUICHE LORRAINE, MUFFINS, FRUIT _____ _____ _____
(**) HOT OATMEAL CAN BE ADDED TO ANY FULL BREAKFAST BY REQUEST
SPECIFY NUMBER OF PERSONS REQUESTING AND DATE OF BREAKFAST __________________________________________
(**) $4.50 EACH PERSON CONTINENTAL BREAKFAST
_______(7) FRUIT, MUFFINS, SAME LIQUIDS AS ABOVE _____ _____ ____
LUNCH 12 NOON LUNCHES SERVED WITH VEGETABLE TRAY OR SALAD, LEMONADE, MILK ,COFEE, TEA AND DESSERT
________(1) SOUP AND SALAD , BREAD LOAF OR FRENCH BREAD _____ _____ _____
________(2) HOME STYLE BAKED MACARONI & CHEESE, CORN BREAD, OR BISCUITS (CIRCLE CHOICE) _____ _____ _____
________(3) HAMBURGER STEW , BISCUITS OR CORNBREAD (CIRCLE CHOICE) FRUIT TRAY _____ _____ _____
________(4) SPAGHETTI, FRENCH BREAD, _____ _____ _____
________(5) DELI TURKEY SANDWICHES, 3 BREAD CHOICES, CHEESE, CHIPS _____ _____ _____
________(6) SALAD BAR (COOKS CHOICE) ITALIAN BREAD OR BREAD LOAF _____ _____ _____
________(7) HAMBURGERS, CHEESE, CHIPS & ALL THE TRIMMINGS _____ _____ _____
________(8) BAKED POTATO BAR, FRENCH BREAD OR BREAD LOAF (CIRCLE CHOICE) _____ _____ _____
________(9) NACHO GRANDE’ (BUILD YOUR OWN – ALL THE TRIMMINGS) FRUIT TRAY _____ _____ _____
DINNER 5:30 PM DINNERS SERVED WITH HOT VEGETABLE, SALAD, ROLL, MILK COFFEE, TEA, DESSERT
________(1) BAKED CHICKEN (LIGHT & DARK MEAT) WITH BBQ SAUCE OR PLAIN (CIRCLE CHOICE)
POTATO OR WILD RICE _____ _____ _____
________(2) HOME MADE LASAGNA – MEAT, VEGIE OR BOTH (CIRCLE CHOICE) , FRENCH BREAD _____ _____ _____
________(3) MEATLOAF, MASHED POTATOES, GRAVY, _____ _____ _____
________(4) POT ROAST WITH MASHED POTATOES (CIRCLE ONE) OR WILD RICE _____ _____ _____
________(5) BARBECUED BONELESS PORK SPARERIBS, BAKED POTATOES _____ _____ _____
________(6) CHICKEN MONTEREY (BAKED CHICKEN BREAST STUFFED WITH CHEESE & ROLLED IN
HERB BREAD COATING) WILD RICE _____ _____ _____
________(7) TURKEY BRIRE WITH WILD RICE _____ _____ _____
________(8) CREAMY CHICKEN ENCHALADAS, SPANISH RICE _____ _____ _____
GRAND TOTAL FOR ALL MEALS $___________
MEAL SERVING TIMES: 8AM, 12 NOON, 5:30PM UNLESS PRE-ARRANGED TIMES ARE AGREED UPON
BRING YOUR OWN SNACKS O.K. - POP MACHING AVAILABLE - HOT DRINKS AVAILABLE ALL DAY
GROUP MEAL PLANNING ONLY ( 1 CHOICE EACH MEAL)
FEE MUST BE PAID TWO WEEKS IN ADVANCE OF ARRIVAL – NO REUNDS WILL BE MADE ON PRE-PAID MEALS
ALL MEALS SERVED BUFFET STYLE - ALL GROUPS BUSS THEIR OWN TALBES - NO KITCEN CLEAN-UP
SOME LAST MINUTE MEAL RESERVATIONS ALLOWED – CHECK FOR DETAILS IF THIS APPLIES TO YOUR GROUP
BE SURE AND ADVISE YOUR GROUP OF MEAL CHOICES – ANY SPECIAL DIETARY REQUIEMENTS MUCT BE PRE-ARRANGED
QUESTIONS - PLEASE CALL NUMBER BELOW
RETURN FORM - FILLED OUT - ALONG WITH YOUR CHECK FOR MEALS BY DATE
SIGNED____________________________________ PHONE NUMBER_________________________
CONTACT PERSON FOR MEALS DAY & EVENING NUMBER
ORGANIZATIONAL NAME ARRIVAL DATE ___________
MAIL TO: 37936 SE GORDON CREEK ROAD PHONE # 503-695-2418
CORBETT, OREGON 97019 ATTN: MONICA BROCATO