2019 Box Lunch Order Form

2019 Box Lunch Order Form

Thursday, April 11, 2019
IT'S LUNCH TIME!

Please fill out this entire order form for your team. Should you have any questions prior to ordering, please contact us at 519-627-0777 ext. 2101
Business Name
Enter Business Name Here
Contact Name

First NameLast Name
Contact Number*

Area CodePhone Number
E-mail

Every Box Lunch Includes:

A reusable thermal lunch bag, one sandwich, one side, fresh fruit, a bottle of water, and a dessert. Cost per lunch: $10
Sandwich Totals

Please enter the number of each sandwich choice required (one per lunch).
Chicken Caesar on a Kaiser
Ham & Swiss on a Kaiser
Veggie & Cheese on a Kaiser
Delivery Option (choose one)

Delivered between 10:30 a.m. and 11:30 a.m.Delivered between 11:30 a.m. and 12:30 p.m.I will pick up my order at the UAW Hall (88 Elm Drive, Wallaceburg) after 11:00 a.m.
Delivery Address (required for all orders)*

Street Address

Street Address Line 2

CityProvince

Postal CodeCountry
Special Instructions for Delivery (side door, buzzer #, etc)
Payment Option

Exact cash or cheque upon deliveryPlease contact me for credit card pre-payment
Additional Requests
Thank you for your support!

Proceeds will enhance programs and services to more than 400 individuals who have an intellectual disability and their families across Chatham-Kent.
Should be Empty:

IT'S LUNCH TIME!