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Fax Order Form 10296 Main St at Old Lee Hwy

YOUR NAME PHONE COMPANY PICK UP TIME

1  PAGE #: OF:

2 Fill in sections below and fax this page to: 703-218-9821


3  Call the restaurant to make sure we’ve received your fax order: 703-218-4400
4  Come in at your requested pick up time. Skip the lines and go directly to the PICK UP sign. Last but not least, (please) no separate checks.
Noodles, Soups, Salads & Trios
NAME SIZE PROTEIN (included in TRIO) SIDES & EXTRAS
NOODLES, SOUP OR SALAD chicken, parm-crusted chicken, beef SPECIAL REQUESTS
please print circle one 1 side soup or side salad included in Trio
shrimp, meatballs, organic tofu

X E x am p l e REG SM TRIO Penne Rosa, feta chicken breast Green Salad w/balsamic no mushrooms, extra spinach
1 REG SM TRIO

2 REG SM TRIO

3 REG SM TRIO

4 REG SM TRIO

5 REG SM TRIO

6 REG SM TRIO

7 REG SM TRIO

8 REG SM TRIO

Extras & Desserts Drinks


QTY QTY QTY QTY

Cucumber Tomato Salad  Ciabatta Roll  Fountain Drinks REGULAR  Bottled Juices &
Beverages 
  LARGE 
Tossed Green Salad Flatbread Milk REGULAR 
CHECK DRESSINGS: KID'S 
 BALSAMIC  SESAME SOY
 FAT-FREE ASIAN  MED  CAESAR
Rice Krispy Treats  CHOCOLATE 
Fresh-Brewed REGULAR 
Potstickers ORDER
OF 3  ORDER
OF 6  Chocolate Chunk Cookies  Iced Tea
LARGE 
Snoodledoodle Cookies 

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