Fax Order Form Please call the store after faxing

							                                                              Delivery __ Pick-Up __ Who will pick up? ______________
                                                              Customer Contact: ___________________________________
                                                              Delivery Address: ____________________________________
                                                              ___________________________________________________

              Fax Order Form                                  ___________________________________________________
      Please call the store after faxing to                   Phone Number: ______________________________________
           confirm receipt of order                           Delivery/Pickup Date:________________ Time:____________
                                                              Special Delivery Instructions: ___________________________
                     TASTE® Use Only:
                                                              ___________________________________________________
     Confirmed By:__________________ Date_________

                                                                      Box Lunch
                                                                       Upgrade
                                                              Exec = chips & cookie
                                                              VIP = potato, pasta or
    Person’s Name    Sandwich or        Toppings or Special   fruit salad & dessert bar   Side(s)/
      Or Initials       Salad              Instructions       (see page 2 for choices)     Chips        Dessert    Beverage(s)

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                        Customer: __________________________________________________________________________
                                  Page ___ of ___        Pickup or Delivery Date:______________ Time: _____________




                                                                                                Box Lunch
                                                                                                  Upgrade
                                                                                         Exec = chips & cookie
      Person’s Name            Sandwich or               Toppings or Special             VIP = potato, pasta or             Side(s)/
#       Or Initials               Salad                     Instructions                 fruit salad & dessert bar           Chips            Dessert        Beverage(s)




Deep River Chips Varieties: Original Salted, Salt & Cracked Pepper, Rosemary & Olive Oil, Zesty Jalapeño, Lightly Salted (Reduced Fat), Sweet Maui Onion, Mesquite BBQ
          Cookie Varieties: Chocolate Chunk, Oatmeal Raisin, Snickerdoodle, Cranberry-White Chocolate Chunk, Peanut Butter, Chocolate Dipped Macaroons
                                    Dessert Bars: Lemon, 7-Layer, Key West, Oreo, Raspberry, Pecan, Brownies, Marbled Brownies
                      Coke, Diet Coke, Sprite, Sprite Zero $1.69 • Honest Teas $1.99 • Gold Peak Teas $ 1.69 • Taste™ Bottled Water $0.99