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Convience Order Form

This document is an order form for convenience trays with a $5 fee. It lists the meal and beverage options available for breakfast, lunch, and dinner, including main dishes, sides, and drinks. Customers can choose their meals and mark their preferences for items like coffee and dessert. They also provide their name, apartment number, and whether they will pick up or have the tray delivered.

Uploaded by

Hannah Lagasse
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
102 views1 page

Convience Order Form

This document is an order form for convenience trays with a $5 fee. It lists the meal and beverage options available for breakfast, lunch, and dinner, including main dishes, sides, and drinks. Customers can choose their meals and mark their preferences for items like coffee and dessert. They also provide their name, apartment number, and whether they will pick up or have the tray delivered.

Uploaded by

Hannah Lagasse
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Convenience Tray Order Form - $5 Fee Applicable for Convenience Trays

BREAKFAST LUNCH DINNER RESIDENT


Fruit of the Day Fresh Baked Bread Soup Name:
Prunes Green Salad Crackers
Hot Cereal Dressing Option 1 Meal
Cold Cereal Option 1 Meal Option 2 Meal
Regular Option 2 Meal Apt #
Alternate Meals
Eggs
Alternate Meals (HC) (CC)
Toast
(HC) (CC)
Coffee (circle) Coffee (circle) Date:
Regular or Decaf Regular or Decaf
Coffee (circle)
Tea Tea
Regular or Decaf
Milk Milk Tea
Juice Dessert (circle) Delivery
Milk
Regular or Reduced Sugar Pick up
Dessert (circle)
Regular or Reduced Sugar
Other: Other: Other:

Holiday Retirement
DS-037 09.26.18 Page 1 of 1

Convenience Tray Order Form - $5 Fee Applicable for Convenience Trays


BREAKFAST LUNCH DINNER RESIDENT
Fruit of the Day Fresh Baked Bread Soup Name:
Prunes Green Salad Crackers
Hot Cereal Dressing Option 1 Meal
Cold Cereal Option 1 Meal Option 2 Meal
Regular Option 2 Meal Apt #
Alternate Meals
Eggs
Alternate Meals (HC) (CC)
Toast
(HC) (CC)
Coffee (circle) Coffee (circle) Date:
Regular or Decaf Regular or Decaf
Coffee (circle)
Tea Tea
Regular or Decaf
Milk Milk Tea
Juice Dessert (circle) Delivery
Milk
Regular or Reduced Sugar Pick up
Dessert (circle)
Regular or Reduced Sugar
Other: Other: Other:

Holiday Retirement
DS-037 09.26.18 Page 1 of 1

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