Elliott Dining Dinner Sack Meal Form

Dining - Elliott Dining 3Dinner Sack Meal Form

eOrder Form for a Dinner Sack Meal (must be submitted by 4:00 p.m. the day prior to pick up)

Dinner Meal Equivalency = $7.55 (Fall and Spring 2009-2010) If items ordered exceed this amount, overage will need to be paid with Dining Plus, Cardinal Ca$h, or when sack meal is picked up, cash, personal check, Visa, or Master Card.

Items with an * indicate a required field.

Date needed *
Time of Day you will pickup/ pay for your meal? *
First Name *
Middle Initial *
Last Name *
Address Line 1 *
Address Line 2
Phone *
Email *
Fruit and Juice	Apple, Whole $.50 Orange, Whole $.50 Banana, Whole $.50 Apple Sauce, 4 oz cup $.50 Peaches, 4 oz cup $.50
Eggs and Dairy	Yogurt, Raspberry Lite $.95 Yogurt, Strawberry Banana Lite $.95 Yogurt, Blueberry $.95 Yogurt, Cherry $.95 Yogurt, Strawberry $.95 Milk, Silk Soy Vanilla $1.99 Milk, Silk Soy Chocolate $1.99 Milk, Silk Soy Regular $1.50 Pudding Cup, Chocolate $.99 Pudding Cup, Vanilla $.99 Pudding Cup, Butterscotch $.99 Milk, 2% pt $1.09 Milk, Fat Free pt $1.09 Milk, Chocolate pt $1.09 Jello Cup (flavor of the day) $.99 String Cheese $1.25
Entree	Sandwich, Triple Deck PB&J on White $1.25 Sandwich, Triple Deck PB&J on Wheat $1.25 Sandwich, Wheatberry w/1 Deli Meat & 1 Cheese $4.95 Sub Bun, White w/1 Deli Meat & 1 Cheese $4.95 Wrap, White w/1 Deli Meat & 1 Cheese $4.75 Wrap, Wheat w/1 Deli Meat & 1 Cheese $4.75 One Deli Meat Choice - Turkey One Deli Meat Choice - Ham One Deli Meat Choice - Roast Beef One Deli Meat Choice - Chicken One Deli Meat Choice - Veggie One Cheese Choice - American Cheese One Cheese Choice - Swiss Cheese
Side Items	Chef Salad with Ham $4.50 (select dressing below) Chef Salad with Turkey $4.50 (select dressing below) Chef Salad with Chicken $4.50 (select dressing below) Chef Salad - Veggie $4.50 (select dressing below) Tossed Side Salad $1.25 (select dressing in condiments) Cookie, Chocolate Chip $.50 each Cookie, Peanut Butter $.85 each Cookie, Polka Dots $.50 each Cookie, Oatmeal Raisin $.85 each Stix, Celery and Carrots $1.09 Stix, Broccoli and Cauliflower $1.09 Chips, Sun Chips $.35 Pretzels $.50
Beverages	BSU Water $1.05 Gatorade, Riptide Rush 20oz. $1.59 Gatorade, Orange 20oz. $1.59 Gatorade, Lemon Lime 20oz. $1.59 Gatorade, Fruit Punch 20oz. $1.59
Condiments (use Comments to order extras)	Catsup n/c Mustard n/c Miracle Whip n/c Mayonnaise n/c Salt Packet n/c Pepper Packet n/c French Lite Dressing n/c Ranch Dressing n/c Ranch Lite Dressing n/c Italian Lite Dressing n/c Sugar Packet $.50 ea (use Comments to order more)
If meal exceeds $7.55, overage on...?	Dining Plus Cardinal Cash Cash (payable at pick up) Personal Check (payable at pick up) Debit or Credit Card (payable at pick up)
Comments and Special Instructions

Substitutions may be made if the dining unit is 'out of stock' for an item you have requested.