DePaul Catholic Ordering Form- Moe's Southwest Grill

DePaul Catholic- Moe's Southwest Grill Meal Kit Order Form

Enter all information below to order for DePaul Catholic's Meal Kit Pop-Up on Wednesday, June 9th. There are two pick up times 4:30-5:30pm and 6:45-7:45pm. Please make sure to choose your time in the drop down menu. Pick up will be at the Moe's of Pompton store located at 500 State Route 23, Pompton Plains, NJ 07444.
Full Name *

First Name Last Name
E-mail *
Phone *

Area Code Phone Number
Choose a Pick-Up Time

How Hungry Are You? - Please make sure you are checking off the box for the items you want to purchase in order for it to show in your total. After checking the box, select the quantity and your choice of protein.

Nacho Meal Kit $ 29.99

Includes: Chips, Choice of Protein(s), Beans, Pico de Gallo, Sour Cream, Salsa, Jalapenos, and 2 Bowls of Queso

Quantity Choice of Protein

Taco Meal Kit $ 34.99

Includes: 12 Soft Tortillas, Choice of Protein(s), Rice, Beans, Cheese, Lettuce, Pico de Gallo, Sour Cream, Chips, Salsa and Queso

Quantity Choice of Protein

Fajita Meal Kit $ 39.99

Includes: 12 Soft Tortillas, Choice of Protein(s), Rice, Beans, Green Peppers and Onions, Lettuce, Pico de Gallo, Sour Cream, Guacamole and a Bowl of Queso

Quantity Choice of Protein

Bowl of Guacamole $ 5.00

Quantity

Total $ 0.00

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Date	Postal Code

If you are having difficulties submitting/completing your Moe's Meal Kit order online through Jotform, please email your order directly to the Moe's of Pompton store: pompton@moesofnj.com with the Attention: "Frank".

In your email please include: Name, Cell Phone Number, Meal Kit & Protein selection. To complete your order, Moe's will contact you directly, for your Credit Card payment.
Should be Empty:

DePaul Catholic- Moe's Southwest Grill Meal Kit Order Form