JAN 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

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Date*

Date

VEG - Lemon Rice, Masal Vadai, Chappathi, Veg Fry.

N-VEG - Lemon Rice, Masal Vadai, Chappathi, Chicken Fry.

VEG - Ghee Rice, Veg Salna, Chappathi, Veg Kola.

N-VEG - Ghee Rice, Egg Salna, Chappathi, Veg Kola.

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

NON VEG - Carrot Rice, Aloo Mutter, Poori, Chicken Masala.

VEG - Veg Thalapakatti Biryani, Gobi-65, Raita.

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

Address*

Street Address

Street Address Line 2

CityState

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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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Email*

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