Care Oregon Order Form

Tuesday Delivery Date *

MM

DD

YYYY

Name *

First Name

Last Name

Phone *

(###)

###

####

Delivery Zone *

ZONE 1 (20MIN OR LESS FROM 97209) Flat Rate: $10.00 per order, ZONE 2 ( 25 -40MIN FROM 97209) Flat Rate: $15.00 per order

One

Two

Other

Address *

Please enter the address you want your meal delivered to.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Tuesday Main *

Please choose one meal from the menu options for your Tuesday meal. All meals are family style, 1 meal choice for all family members. Vegetarian choice write in box below.

Beef spaghetti garlic bread and salad

Honey chipotle chicken sw rice broccoli

Blackened tilipia red beans and rice Cabbage

Chef saled with turkey tomaroes boiled egg cucumber cheese Ranch dressing rolls fruit

Vegetarian/vegan Option -Choice tofu or veggie patty / any items above can be converted

Tuesday Dessert

Please choose one dessert from the options for your Tuesday meal.

Lemon Tart

Brownie

Cookie

Friday Main *

Please choose one meal from the menu options for your Friday meal. All meals are family style, 1 meal choice for all family members. Vegetarian choice write in box below.

Beef spaghetti garlic bread and salad

Honey chipotle chicken sw rice broccoli

Blackened tilipia red beans and rice Cabbage

Chef saled with turkey tomaroes boiled egg cucumber cheese Ranch dressing rolls fruit

Vegetarian/vegan Option -Choice tofu or veggie patty / any items above can be converted

Friday Dessert

Please choose one dessert from the options for your Friday meal.

Lemon Tart

Brownie

Cookie