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BRAKE FOR BURRITOS
April 17, 2019 - CASH or CHECK only please
Supporting Meals on Wheels of Erath County
Presented by Leadership Stephenville, Class of 2019
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Contact Name (First and Last)
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Phone Number
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Egg/Cheese/BACON - Order Quantity - must be in increments of 2 (cost is 2/$5) CASH or CHECK only please
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Choose
No Egg/Cheese/Bacon
2 - $5.00
4 - $10.00
6 - 15.00
8 - $20.00
10 - $25.00
12 - $30.00
14 - $35.00
16 - $40.00
18 - $45.00
20 - $50.00 (qualifies for free delivery)
More than 20 - Please enter information in next section
Egg/Cheese/Bacon Quantity over 20
Your answer
Egg/Cheese/SAUSAGE - Order Quantity - must be in increments of 2 (cost is 2/$5) CASH or CHECK only please
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Choose
No Egg/Cheese/Sausage
2 - $5.00
4 - $10.00
6 - 15.00
8 - $20.00
10 - $25.00
12 - $30.00
14 - $35.00
16 - $40.00
18 - $45.00
20 - $50.00 (qualifies for free delivery)
More than 20 - Please enter information in next section
Egg/Cheese/Sausage Quantity over 20
Your answer
Pick Up or Delivery (order must be over $50.00 for delivery) CASH or CHECK only please
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Pick Up
Delivery
Pick Up Time (pick up will begin at 6:30am at City Park pavilion)
Time
:
AM
PM
Delivery Address (if order is over $50 and you want delivery)
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Special Instructions / Notes
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