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Food Order Form Example Food Order Shopping Cart Example

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Food Order Form
Appetizers & Side Orders
ItemSelectionQuantityAction
Soup of the Day:
Side Salad:
Small
*Dressing
Italian Ranch Blue Cheese Honey Mustard Vinaigrette 
Side Salad:
Large
*Dressing
Italian Ranch Blue Cheese Honey Mustard Vinaigrette 
French Fries:
Small
French Fries:
Large
Submarine Sandwiches
ItemSelectionQuantityAction
Submarine Sandwich
Steak & Cheese
Submarine Sandwich
Ham & Cheese

CategoryDrinks & DessertsQuantityAction
Drinks:
Coke Sprite Dr. Pepper Root Beer Diet Coke 
Desserts:
Sub-Total:
Coupon Code (5%)
Tax (AZ 8.1%):
Grand Total:
Customer E-Mail
Important: Enter a valid e-mail address. Receipts will be sent to this address.
*E-Mail:
Billing Information
*First Name:Same name as on your card
Middle Initial:
*Last Name:
*Address Line 1:Where your statement is mailed
Address Line 2:Apt. or Suite No.
*City:
*State:
*Zip Code:
Phone:
Delivery Information
*Same as billing info
Yes No 
*First Name:
Middle Initial:
*Last Name:
*Address Line 1:
*Address Line 2:
*City:
*State:
*Zip Code:
Payment Information
*Payment Method:
Credit Card Cash on Delivery (C.O.D.) 
*Card Number:No dashes or spaces please
*Expiration Month:From your card
*Expiration Year:From your card
*Card Brand:
Reset 
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