APR Order Form

Name*

Phone Number*

Please enter your phone number.Format: (000) 000-0000.

Location*

Please choose delivery locations

AMAZON BELLEVUE BUILDINGS*

Please choose from BELLEVUE buildings

AMAZON SEATTLE BUILDINGS*

Please choose from SEATTLE buildings

Enter Amazon Building Name*

Date*

Date

VEG - Potato Curry Rice, Poori, Fryums, Veg Fry.

N-VEG - Potato Curry Rice, Poori, Fryums, Chicken Fry.

VEG - Veg Biryani, Gobi 65, Raita.

N-VEG - Chicken Biryani, Chicken 65, Raita.

VEG - Carrot Rice, Aloo Mutter, POORI, Veg Masala.

NON VEG - Carrot Rice, Aloo Mutter, POORI, Goat Masala.

VEG - Coconut Rice, Chappathi, Medhu Vada, Aloo curry.

N-VEG - Coconut Rice, Chappathi, Medhu Vada, Chicken curry.

Address*

Street Address

Street Address Line 2

CityState

Zip Code

PLEASE SELECT USING CHECK BOX

My Products*

Veg

$12.00 Quantity

Non-Veg

$14.00 Quantity

Enter coupon

Subtotal

$0.00

Tax

$0.00

Total

$0.00

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